Miyahara H
Gan To Kagaku Ryoho. 1987 Jun;14(6 Pt 1):1804-11.
Between 1978 and 1983, ninety-three patients with cancer of the hypopharynx were treated. They were evaluated as to sex, age, primary site, TNM classification, stage, habits of smoking and drinking, past history of irradiation, treatment modality and end results. Eighty-seven percent of the patients visited us at as late a stage as advanced stage III or IV, and were treated mainly by combined therapy involving irradiation and pharyngolaryngoesophagectomy. The 3-year and 5-year survival rates were 38.6% and 33.3%, respectively. After December 1983, 14 new patients with advanced disease including three with coervical esophageal cancer were treated with neo-adjuvant combination chemotherapy which included cisplatin, peplomycin, methotrexate, and bleomycin over two courses of therapy. The response rate (CR + PR) was high, being 82% for the primary tumor and 78% for the metastatic node. Histopathological effects of neo-adjuvant chemotherapy were studied in the resected specimens. The evaluation was based on the Ohboshi-Shimosato classification. The histological effects did not agree with the clinical effects. Grade II b change was evaluated mostly in CR cases and grade II a change was seen in PR cases. It thus seems that neo-adjuvant chemotherapy prior to surgery and/or radiation including cisplatin and other agents is very useful as a multidisciplinary treatment for cancer of the hypopharynx.
1978年至1983年间，对93例下咽癌患者进行了治疗。对他们的性别、年龄、原发部位、TNM分类、分期、吸烟和饮酒习惯、既往放疗史、治疗方式及最终结果进行了评估。87%的患者就诊时已处于晚期Ⅲ期或Ⅳ期，主要采用放疗和下咽-喉-食管切除术联合治疗。3年和5年生存率分别为38.6%和33.3%。1983年12月以后，对14例晚期新发病例（包括3例合并颈段食管癌患者）采用新辅助联合化疗，化疗方案包括顺铂、培普利霉素、甲氨蝶呤和博来霉素，共两个疗程。缓解率（CR + PR）较高，原发肿瘤为82%，转移淋巴结为78%。对切除标本研究了新辅助化疗的组织病理学效应。评估基于大星-下里分类法。组织学效应与临床效应不一致。Ⅱb级改变大多见于CR病例，Ⅱa级改变见于PR病例。因此，术前和/或放疗前采用包括顺铂及其他药物的新辅助化疗作为下咽癌的多学科治疗似乎非常有效。
