進行頭頸部癌の治療 : 対応と問題点  [in Japanese] Treatment of Advanced Head and Neck Cancer : Problems and Management  [in Japanese]

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Author(s)

Abstract

The results of planned combination therapy in patients with advanced head and neck cancer, particularly maxilla and hypopharynx, at Akita University School of Medicine (-1996), and at Yamanashi Medical University (1996-) were reviewed. Combination therapy consisted of a full dose irradiation together with chemotherapy followed by en bloc resection and primary reconstruction. Retrospective analysis of the patients with maxillary cancer showed that en bloc resection seemed to be adequate, but in some cases, irradiation combined with chemotherapy without maxillectomy was useful. In the treatment of advanced hypopharyngeal cancer, the histopathological effects (pT, pN) of preoperative chemotherapy and radiotherapy were the most important factors in prognosis. In paticular, the presence of pN predicted a very low possibility of survival and a very high incidence of distant metastasis. The advantages and disadvantages of preoperative radiotherapy are also discussed.<br>Finally, the treatment of head and neck carcinoma involving the carotid artery was also reviewed; Carotid artery resection is the only modality therapy offering the potential for care. However, aggressive resections involving the carotid artery should include the reconstruction of this vessel with a graft, particularly in cases where extensive resection of the skull base including the carotid canal and sigmoid sinus is performed. Preoperative temporary occlusion of the carotid artery is not necessarily an accurate predictor of morbidity after permanent occlusion. In extracranial-intracranial bypass surgery, temporary occlusion of middle cerebral artery also may induce serious brain ischemia, but our finding show that two-stage extracranial-intracranial bypass surgery may minimize this risk.

Journal

  • Practica Oto-Rhino-Laryngologica

    Practica Oto-Rhino-Laryngologica 94(7), 577-585, 2001-07-01

    The Society of Practical Otolaryngology

References:  26

Codes

  • NII Article ID (NAID)
    10008096890
  • NII NACSIS-CAT ID (NCID)
    AN00107089
  • Text Lang
    JPN
  • Article Type
    ART
  • ISSN
    00326313
  • NDL Article ID
    5833249
  • NDL Source Classification
    ZS43(科学技術--医学--耳鼻咽喉科学)
  • NDL Call No.
    Z19-421
  • Data Source
    CJP  NDL  J-STAGE 
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