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中咽頭扁平上皮癌に対する計画的頚部郭清術の意義に関する研究

计划性颈清扫术治疗口咽鳞状细胞癌的意义研究

基本信息

批准号：
18791234
负责人：
冨田俊樹
金额：
$ 2.05万
依托单位：
Keio University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Young Scientists (B)
财政年份：
2006
资助国家：
日本
起止时间：
2006 至 2007
项目状态：
已结题

项目摘要

頸部転移優位型の4期中咽頭癌に対しドセタキセル併用放射線療法および一部の症例にPlanned neck dissection(PND、計画的頸部郭清術)を施行した。治療成績と本治療法の役割を検討した。方法:2001〜06年に慶礁病院で治療を行ったT1-3, N2-3, MOの4期中咽頭扁平上皮癌23例を対象とした。放射線治療は30回60 Gy、ドセタキセル点滴静注は10 mg/m2/週、計6回を目標とした。原発巣のCRを確認した症例の一部に対し放射線治療終了後6〜8週目にPNDを施行した。結果:TN分類はT1が2例(9%);T2が11例(48%) ; T3が10例(43%)、N2が19例83%) ; N3が4例(17%)であった。平均観察期間は38ケ月であった。グレード3の粘膜炎は70%に、皮膚炎は30%に認められた。1例のみ原発巣がCRに至らなかった。PNDを施行した10例中4例(40.0%)は組織学的に癌細胞が残存していた。全23例の3年全生存率は82.6%、疾患特異的生存率は87.0%、原発制御率は87.0%、頸部制御率は78.3%であり、PND施行群と非施行群の間にいずれも有意差を認めなかった。結論:本治療法はT1-3, N2-3の4期中咽頭癌に対し良好な成績を示した。全例にPNDを行う必要はないがPNDが頸部制御に寄与する可能性が高い。頸部転移優位型の4期中咽頭癌に対して少量化学放射線療法士計画的頸部郭清術という治療戦略は検討されるべきである。化学療法や射線療法を強化しても大きなメリットは得られないかもしれない。

Planned neck dissection (PND, planned Guo Qingyuan) was performed in stage 4 pharynx cancer with radiation therapy. To cure the disease is to treat the original method, to cut the pain in service, to cut the pain, to cure the disease. Methods: from 2001 to 2006, 23 patients with pharynx flat epithelial carcinoma in stage T1-3, N2-3, MO stage 4 were treated in Yuejiao Hospital. The patients were treated with radiotherapy for 30 times (60 Gy), intravenous injection of 10 mg/m2/ (intravenous drip) and 6 cycles (6 times). The original CR confirmed that the patient was treated with radiation therapy, and then the PND was performed in 6 months and 8 months. Results: according to TN classification, T1 was found in 2 cases, T2 in 11 cases, T3 in 10 cases, N2 in 19 cases, and N3 in 4 cases (17%). The average probation period is 38 months. The symptoms are mucositis (70%) and dermatitis (30%). In 1 case, the original symptoms were from CR to normal. Of the 10 cases performed by PND, 4 cases (40.0%) underwent histological examination of residual cancer cells. In all 23 cases, the 3-year overall survival rate was 82.6%, the disease specific survival rate was 87.0%, the original control rate was 87.0%, the department control rate was 78.3%, and the PND group was non-executive group. Results: in the treatment of stage T1-3 and N2-3, pharynx cancer showed good results. For the whole PND line, it is necessary to send it to the PND department that the possibility is high. In the fourth stage of pharynx cancer, a small amount of chemoradiotherapy was designed by Fashi Guo Qingyi for treatment of pharyngeal cancer. The chemical method, the X-ray method, the chemical method and the chemical method.