N2頸部リンパ節転移の術前治療後頸部郭清による制御と病理学的検討

A study of regional control and pathological examination on N2 neck nodal diseases after the treatment with chemotherapy,radiation in addition to neck dissection

Ⅰ．はじめに

　20年来，当科では頭頸部扁平上皮癌に対する術前治療として，基本として全例に放射線治療を行ってきた。さらに1989～2005年まではinduction chemotherapy（ICT）と併用し，2006年以降はconcurrent chemoradiotherapy（CCRT）で術前治療を行い，手術の適応があれば適切な評価の基に施行する集学的治療を一貫して続けてきた。

　今回N2頸部リンパ節転移症例を取り上げ，術前治療および頸部郭清後の郭清野の制御効果と病理学的検討を行ったのでここに報告し，もって手術を含めた集学的治療の重要性を強調したい。

　In 48 cases of N2 nodal disease in head and neck squamous cell carcinoma treated with neck dissection after primary chemoradiation or radiation alone,we studied the efficacy of treatments such as the regional disease control ratio and the pathological CR ratio. The 3-year regional control ratio was 89.9％ which was significantly better than that of the other reports without preoperative therapies. The pathological CR ratio dissolved in the resected nodes was 54.2％. Consequantly promising therapy of neck nodal disease is a comprehensive treatment using chemotherapy,radiation in addition to adequate neck dissection.