de Bree Remco
Department of Head and Neck Surgical Oncology, UMC Utrecht Cancer Center, University Medical Center Utrecht, Utrecht, The Netherlands,
Adv Otorhinolaryngol. 2019;83:76-89. doi: 10.1159/000492314. Epub 2019 Feb 12.
The management of hypopharyngeal cancer is challenging because of poor patient survival and the potential effects of treatment on breathing, voice and swallowing. In general, early stage hypopharyngeal cancer can be primarily treated by radiotherapy or conservative transoral or open surgery, whereas advanced stage hypopharyngeal cancer can be treated by non-surgical protocols if the patient has no loss of functions (dysfunctional larynx) and/or cartilage invasion (T4a). Factors to determine individualized patient treatment include resectability, tumour volume, distant metastases, comorbidity, age, patient's preference, functional imaging parameters, response on induction chemotherapy and employing functional imaging parameters performed in the pre-treatment phase and repeated in the early treatment phase when employing a non-surgical treatment strategy.
下咽癌的治疗颇具挑战性，这是由于患者生存率低，以及治疗对呼吸、发声和吞咽可能产生的影响。一般而言，早期下咽癌可主要通过放疗或保守的经口或开放手术进行治疗，而晚期下咽癌如果患者没有功能丧失（喉功能障碍）和/或软骨侵犯（T4a），则可通过非手术方案进行治疗。决定个体化患者治疗的因素包括可切除性、肿瘤体积、远处转移、合并症、年龄、患者偏好、功能成像参数、诱导化疗反应，以及在采用非手术治疗策略时，运用治疗前阶段进行的功能成像参数，并在治疗早期阶段重复进行。
