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Clinicopathological Research of Treatment of Hypopgaryngeal Cancer Based on Quality of Life

基于生活质量的下咽癌治疗的临床病理学研究

基本信息

批准号：
11671717
负责人：
MORI Kazunori
金额：
$ 2.05万
依托单位：
Kinki University (2000-2002)Kurume University (1999)
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
1999
资助国家：
日本
起止时间：
1999 至 2002
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-11671717/
关键词：
carcinoma of the hypopharynx tumor marker laser surgery origin unknown neck carcinoma carcinoma of the tongue quality of life 放射線治療小児悪性腫瘍がん遺伝子頸部郭清 p-53 Ki-67 PD-ECGF VEGF

项目摘要

1. As for the patients of hypopharyngeal cancer, their p53, Ki-67, PD-ECGF and VEGF were investigated. These tumor markers had no significant relationship with absence/presence of regional or distant recurrence after the initial treatment. These markers were regarded as no effective prognostic factors.2. To acquire better quality of life, laser debulking surgery prior to radiotherapy was conducted for T1T2 carcinoma of the hypopharynx. As a result, three-year local control rate, three-year larynx conservation rate, and three-year cause specific survival rate were 88%, 92%, and 92%, respectively. In addition, in patients who had undergone this procedure, few underwent tracheostomy, all could had oral diet from the next day of the operation, and none underwent total laryngectomy due to aspiration.3. Since some patients with carcinoma of the hypopharynx visit the hospital complaining of origin unknown neck tumor, the relationship between the site of neck metastasis and primary origin was investigated. As a result, when neck metastases were squamous cell carcinomas and were confined to upper or middle jugular areas, affected-side tonsillectomy was regarded as one of reliable methods to know the primary origin.4. Since carcinoma of the hypopharynx sometimes suffered from carcinoma of the tongue simultaneously, T1T2 carcinoma of the tongue was investigated. As a result, the prophylactic neck dissection would be indicated only when the patients and/or their family approved after detailed explanation about the advantage and disadvantage of this treatment. Supra-omohyoid neck dissection would be satisfactory as an initial treatment. Prognostic factors of neck metastases were depth of the invasion, vascular invasion, and muscular invasion of the primary tumor.

1.对下咽癌患者进行p53、Ki-67、PD-ECGF、VEGF的检测。这些肿瘤标志物与初始治疗后局部或远处复发的存在/不存在无显著关系。这些指标均不能作为有效的预后因素.为了提高患者的生活质量，我们对T1 T2下咽癌患者在放疗前进行了激光减积手术。结果，3年局部控制率、3年喉保存率和3年病因特异性生存率分别为88%、92%和92%。此外，在接受此手术的患者中，很少有患者接受气管切开术，所有患者从手术第二天起都可以口服饮食，没有患者因误吸而接受全喉切除术.由于部分下咽癌患者就诊时主诉颈部肿瘤来源不明，本文探讨颈部转移部位与原发肿瘤的关系。因此，当颈部转移瘤为鳞状细胞癌且局限于颈静脉上段或中段时，患侧扁桃体切除术是了解原发灶的可靠方法之一.由于下咽癌有时同时患有舌癌，因此研究了T1 T2舌癌。因此，只有在详细解释了这种治疗的优点和缺点后，患者和/或其家属同意时，才适用于预防性颈清扫术。肩胛舌骨上颈淋巴结清扫术作为初始治疗是令人满意的。颈部转移的预后因素是原发肿瘤的浸润深度、血管浸润和肌层浸润。