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題 名 | Prognostic Factors Affecting The Outcome of Oropharyngeal Carcinoma=口咽癌之治療結果與預後因子分析 |
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作 者 | 洪儷中; 劉幕台; 陳穆寬; 張正權; 黃家俊; 黃昭源; 畢祖平; 張東浩; 許智捷; | 書刊名 | 放射治療與腫瘤學 |
卷 期 | 15:3 2008.09[民97.09] |
頁 次 | 頁167-179 |
分類號 | 416.89 |
關鍵詞 | 口咽癌; 治療結果; 預後; Oropharyngeal carcinoma; Treatment results; Prognostic factors; |
語 文 | 英文(English) |
中文摘要 | 目的:分析口咽癌患者接受治療的結果與預後因子。材料與方法:自1995年3月到2005年9月,有110位被診斷為口咽癌的病人在本院接受治療。其中男性105位,女性5位。病人的年齡中位數是52歲(範圍介於30至77歲)。有87位病人(79.1%)原發部位為扁桃腺區域,23位病人(20.9%)則為其他部位的口咽。病理組織型態分佈中,分別有10%,62.8%及27.2%的病人為良好分化,中度分化及不良分化。以AJCC分期系統來訂定病人的癌症期別,8.2%的病人是stage Ⅱ,7.3%的病人是stage Ⅲ,69.1%及15.5%的病人分別為stage Iva及stage IVb。有49位病人接受了切除手術,其中有32位病人(佔全體的29%)並接受了輔助性放射治療,另外17位病人(佔全體的15.5%)接受了輔助性同步化學放射治療。17位病人(佔全體的15.5%)接受了根除性放射治療,還有44位病人(佔全體的40%)接受根除性放射治療及化學治療。結果:治療後的追蹤時間中位數是17個月(範圍從2.4至130.2個月)。在追蹤的過程中,39位病人存活(35.5%),71位病人死亡(64.5%)。五年的整體存活率、無疾病存活率及局部區域控制率分別為28.4%,28.8%及58.4%。若以接受治療的組合來看,五年的整體存活率對接受根除性放射治療的病人為24.8%,接受根除性放射治療及化學治療的病人為14.1%,接受手術切除及輔助性放射治療的病人為36.9%,接受手術切除及輔助性同步化學放射治療的病人為45.8%。在單變項分析中,性別、原發部位、病理組織型態以及接受手術與否是重要的預後因子。而在多變項分析中,接受手術是唯一對存活率有統計意義的預後因子,而對於局部區域控制率來說,接受手術以及原發部位是有意義的預後因子。結論:從這篇追溯性的文章來看,接受手術對於口咽癌的存活率及局部區域控制是統計上有意義的預後因子。然而,近年來隨著放射治療技術的進步以及化學治療的加入,在不犧牲治療結果的前提下,器官保存應是現今治療口咽癌的趨勢。 |
英文摘要 | Purpose: This retrospective study is to investigate the treatment results and prognostic factors of oropharyngeal carcinoma. Materials and Methods: From March 1995 to September 2005, 110 patients diagnosed as oropharyngeal cancer received treatments in our institution. One hundred and five patients were male (95.5%) and 5 patients were female (4.5%). The median age of diagnosis was 52 year-old (range, 30-77 years). Eighty-seven patients (79.1%) were diagnosed as tonsillar carcinoma, and 23 patients (20.9%) were diagnosed as carcinoma of other oropharyngeal subsites. Histopathologically, well-differentiated, moderately-differentiated and poorly- differentiated carcinoma were 10%, 62.8%, and 27.2%, respectively. Staging classification were 8.2%, 7.3%, 69.1% and 15.5% for stage Ⅱ, Ⅲ, IVa, and IVb, respectively. Forty-nine patients were treated with resection of primary tumor with or without neck dissection. Thirty-two of all 110 patients (29.0%) received surgery and adjuvant radiotherapy, 17 patients (15.5%) received surgery and adjuvant chemoradiotherapy. Seventeen patients (15.5%) were treated with radiotherapy alone, and 44 patients (40.0%) were treated with definitive radiotherapy plus chemotherapy. Results: The follow-up period ranged from 2.4 to 130.2 months (median, 17 months). During the follow-up period, 39 patients (35.5%) were alive and 71 patients (64.5%) died. Five-year overall survival rate, disease-free survival rate, and loco-regional control rate of oropharyngeal cancer were 28.4%, 28.8%, and 58.4%, respectively. Five-year overall survival rate for the group of RT alone, definitive RT+C/T, OP+ adjuvant RT and OP+ adjuvant CCRT were 24.8%, 14.1%, 36.9%, and 45.8%, respectively. Gender, tumor site, histopathology and surgery significantly predicted survival in univariate analysis. In multivariate analysis, surgery was the only significant predictor for overall and disease-free survival, while tumor site and surgery were the significant predictors for loco-regional control. Conclusion: Surgery was significantly predicted for loco-regional control and overall survival in this retrospective study. However, improving radiotherapy technique and addition of chemotherapy have changed the practice of oropharyngeal cancer in recent years with organ preservation without compromising the treatment results. |
本系統中英文摘要資訊取自各篇刊載內容。