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유도화학요법 및 국소 치료 후 원격전이를 보인 국소 진행성 두경부암 환자군의 임상 특징 및 위험인자에 관한 연구
이혜원(Hye Won Lee),백동훈(Dong Hoon Baek),이경남(Kyung Nam Lee),조은정(Eun Jung Cho),김효정(Hyo Jeong Kim),설영미(Young Mi Seol),송무곤(Moo Kon Song),최영진(Young Jin Choi),신호진(Ho Jin Shin),정주섭(Joo Seop Chung),조군제(Goon Jae 대한두경부종양학회 2011 대한두경부 종양학회지 Vol.27 No.2
Backgrounds:Head and neck cancer is one of the most prevalent cancers in the world. It tends to remain lo-calized at the primary site and regional lymph nodes, but if distant metastasis occurs, it has a poor prognosis. This study was performed to evaluate the prevalence of distant metastasis and to determine the risk factor in local-ly advanced head and neck cancer after induction chemotherapy followed locoregional control therapy. Meth-ods:A retrospective review was performed in 420 patients with locally advanced head and neck cancer who treated with induction chemotherapy followed locoregional control therapy from January 2001 to December 2010. Among them, 31 patients who had distant metastasis as first relapse within 2 years after termination of therapy were analyzed for clinical features and the risk factors of distant metastasis. Results : The overall incidence of distant metastasis was 7.3%. The bone, lung, and liver were the most frequent metastatic organs. In univariate analysis, nodal stage, nasopharyngeal cancer, laryngeal cancer, G3/G4 neutropenia during induction chemother-apy, and concurrent chemoradiotherapy were the influencing factors for distant metastasis. In multivariate analy-sis, advanced N stage and nasopharynx were the risk factors of distant metastasis, and grade 3/4 neutropenia during induction chemotherapy was considered to decrease distant metastasis. Conclusion:This study sug-gests that the advanced N stage is the risk factor of distant metastasis and Grade 3/4 neutropenia during induction chemotherapy can be beneficial against distant metastasis in locally advanced head and neck cancer patients treat-ed with induction chemotherapy followed locoregional control therapy.