RISS 검색 - 국내학술지논문 상세보기

국문 초록 (Abstract)

목 적: 원발병소 불명의 경부림프절 전이의 치료는 각 기관들의 치료원칙에 따라 경부림프절청소술, 림프절 절제술, 방사선치료 및 항암화학치료 등 다양한 조합의 치료가 적용되고 있다. ...

목 적: 원발병소 불명의 경부림프절 전이의 치료는 각 기관들의 치료원칙에 따라 경부림프절청소술, 림프절
절제술, 방사선치료 및 항암화학치료 등 다양한 조합의 치료가 적용되고 있다. 저자들은 서울대학교병원에
서 원발병소 불명의 경부림프절 전이의 치료성적을 분석하고자 하였다. 대상 및 방법: 1981년 7월부터 1999년 6월까지 서울대학교병원 방사선종양학과에서 근치적 또는 수술 후 방사선치료를 받은 39명의 환자들을 대상으로 후향적으로 분석하였다. 방사선치료가 12명에서, 선행항암화학요법 및 방사선치료가 8명에서, 수술 및 수술 후 방사선치료가 18명에서 시행되었고, 1명은 선행항암화학요법, 경부림프절청소청술 및 수술 후 방사선치료를 받았다. 성별은 남자가 31명, 여자가 8명이었고, 연령의 중앙값은 55세였다.결 과: 전체 환자의 5년 생존율은 55%였다. 치료방법에 따라 분석해보았을 때, 수술+방사선치료가 방사선치료 단독 혹은 항암화학요법+방사선치료에 비해 우월한 5년 무병생존율을 보고하였다 (75% vs. 48% vs.19%). 그 외에 원발병소 발현여부가 무병생존율에 유의한 영향을 주는 것으로 나타났다.결 론: 원발병소 불명의 경부림프절 전이의 치료에 있어서 수술적 절제술 및 방사선치료의 병용요법이 방사선치료±항암화학요법에 비해 우월한 무병생존율을 보여주었다. 항암화학요법의 효과에 대해서는 추가 연구가 요망된다.

다국어 초록 (Multilingual Abstract)

Purpose: To analyze the outcome of radiation therapy for patients with a metastatic carcinoma of cervical
lymph nodes from an unknown primary (MUO), and identify the prognostic factors for these patients. Materials and Methods: Between July 1981 and June 1999, 39 patients with MUO underwent radiation therapy with curative intent. Twelve patients were treated with radiation therapy alone (Group 1), 8 with neoadjuvant chemotherapy followed by radiation therapy (Group 2), and 19 with either an excision or neck dissection and postoperative radiation therapy (Group 3). There were 31 males and 8 females, with a median age of 55 years, ranging from 25 to 77 ears. The median duration of follow-up was 38 months, ranging from 3 to 249 months. Results: The 5-year overall survival rate was 55%. According to the treatment modality, the 5-year disease-free survival rates of Groups 1, 2 and 3 were 48, 19 and 75%, respectively (p=0.0324). In addition to the treatment modality, the appearance of the primary site was a significant prognostic factor for disease-free survival (p=0.0085).
Conclusion: Surgical resection and radiation therapy achieves a superior disease-free survival compared to
radiation therapy alone, either with or without chemotherapy. Further investigation is needed to evaluate the
role of chemotherapy in the treatment of MUO.

목차 (Table of Contents)

Introduction
Materials and Methods
Results
Discussion

Introduction
Materials and Methods
Results
Discussion

참고문헌 (Reference)

1 "Unknown primary squamous cell carcinoma metastatic to the neck" 116 : 1388-1393, 1990

2 "Toxicity criteria of the Radiation Therapy Oncology Group and the European Organization for Research and Treatment of Cancer" 31 : 1341-1346, 1995

3 "Squamous cell carcinoma of the head and neck:management after excisional biopsy of a solitary metastatic neck node" 25 : 619-622, 1993

4 "Radiotherapy for metastatic neck nodes from an unknown primary site" 15 : 105-111, 1997

5 "Radiation treatment of cervical lymph node metastases from an unknown primary:An analysis of outcome by treatment volume and other prognostic factors" 35 : 206-211, 1995

6 "Postoperative radiation therapy for cervical lymph node metastases from an occult squamous cell carcinoma" 102 : 884-890, 1992

7 "Postoperative radiation for squamous cell carcinoma metastatic to cervical lymph nodes from an unknown primary site:outcomes and patterns of failure" 20 : 674-681, 1998

8 "Metastatic squamous cell carcinoma of the neck from an unknown primary:management options and patterns of relapse" 24 : 236-246, 2002

9 "Metastatic squamous cell carcinoma of an unknown primary localized to the neck:advantages of an aggressive treatment" 64 : 510-515, 1989

10 "Metastatic carcinoma in the cervical lymph nodes from an unknown primary site: results of bilateral neck plus mucosal irradiation vs. ipsilateral irradiation" 37 : 797-802, 1997