下咽癌之治療－50例之統計分析

Treatment of Hypopharyngeal Cancer - Review of 50 Cases

陳一豪(I-How Chen) ； 呂宜興(Yi-Shing Leu)

《中華民國耳鼻喉科醫學會雜誌》 29卷4期 (1994/08) Pp. 280-286

https://doi.org/10.6286/1994.29.4.280

摘要

1985年9月至1992年2月間，共有50名下咽癌患者在本科接受完整治療及追蹤，其臨床分期依1992年AJCC的TNM系統為：第2期9例(18%)，第3期11例(22%)，第4期30例(60%)，並無第1期病例。治療方式以術前化學治療，手術及放射治療為主。治療結果：3年存活率為2期75%，3期57.1%，4期35.7%，合計47.2%；5年存活率為2期75%，3期57.1%，4期16%，合計30.6%。
所有病例局部復發率12%(6/50)，頸部復發率6%(3/50)。局部及頸部復發的病例除1例在術後4年發現並存活外，其餘皆發生於術後2年內且預後不佳。遠處轉移佔22%(11/50)，預後亦差。另外下咽癌患者常可見頸部淋巴結侵犯並穿越莢膜蔓延(extracapsular spread)，3年存活率為33.3%(10/30)，5年存活率為18.5%(5/27)。至於腫瘤惡性度分級以分化不良者預後最差，分化良好者預後較佳。

關鍵字

下咽癌

並列摘要

From 1985 to 1992, 89 patients were diagnosed as having hypopharyngeal carcinoma and 50 patients were treated and followed in the ENT department of Mackay Memorial Hospital. Eighteen percent of the 50 patients presented with stage II disease, 22% with stage III disease, and 60% with stage IV disease. Treament modalities included pre-operative chemotherapy, surgery and post-operative radiotherapy. Overall survival rates were 47.2% at three years, and 30.6%at five years.
Twelve percent of patients developed local recurrences and 6% developed neck recurrences. Most recurrences occurred within two years after operation. Twenty-two percent of patients had distant metastasis. Among the patients with neck nodes metastasis, 84.6% had extracapsular spread, which was a poor prognostic indicator. Alternatively, a histologic grading of well differentiated squamous cell carcinoma was associated with a better prognosis.

並列關鍵字

hypopharyngeal carcinoma