Induction Chemotherapy with TPF for Diagnosed Nasopharyngeal Carcinoma with Cranial Nerve Involvement and Vocal Cord Palsy

使用誘導式化學治療（TPF）治療鼻咽癌合併腦部迷走神經侵犯及聲帶麻痺

呂學儒(Hsueh-Ju Lu) ； 凌憬峰(Jiing-Feng Lirng) ； 張牧新(Peter Mu-Hsin Chang)

《台灣癌症醫學雜誌》 29卷3期 (2013/08) Pp. 150-154

https://doi.org/10.6323/JoCRP.2013.29.3.6

摘要

局部晚期的鼻咽癌病患合併腦神經侵犯是常見的症狀，而腦神經的分枝喉返神經損傷則是聲帶麻痺的主要原因。大多數惡性腫瘤所造成的喉返神經損傷是由於腫瘤的直接侵犯，但對於鼻咽癌而言，聲帶麻痺則是因為腫瘤直接侵犯或放射治療所造成的聲帶硬化，鮮少個案是因為鼻咽癌的直接侵犯造成喉返神經麻痺。我們提出了一個三十三歲的男性，診斷為復發性鼻咽癌合併腦神經侵犯的個案，在接受誘導式化學治療（TPF）之後，針對原發部位腫瘤，達到良好的局部治療效果，也因此改善因顱神經侵犯所造成的聲帶麻痺的現象。

關鍵字

鼻咽癌 ； 腦神經侵犯 ； 聲帶麻痺 ； 誘導式化學治療

並列摘要

Cranial nerve involvement is not uncommon in patients with locally advanced nasopharyngeal carcinoma. Vocal cord palsy is the major presentation of a recurrent laryngeal nerve injury, which is a branch from the cranial nerves. Most malignancies with recurrent laryngeal nerve injury are due to direct involvement. But for nasopharyngeal carcinoma, the etiology of vocal cord palsy usually arises from direct tumor invasion or fixation after radiotherapy. However, there have been rare cases which presented with recurrent nerve paralysis due to direct nasopharyngeal carcinoma involvement. In this report, we present the case of a 33-year-old male with recurrent nasopharyngeal carcinoma and cranial nerve involvement. Vocal cord palsy without direct tumor invasion was also diagnosed by laryngoscope. The patient received induction chemotherapy with TPF (docetaxel, cisplatin, 5-FU), and good partial response of the primary tumor was achieved. Additionally, vocal cord palsy due to cranial nerve involvement also improved after induction chemotherapy was completed.

並列關鍵字

nasopharyngeal carcinoma ； cranial nerve involvement ； vocal cord palsy ； induction chemotherapy