中耳扁平上皮癌の臨床

Squamous Cell Carcinoma of the Middle Ear

I．はじめに

　聴器癌は一般の耳鼻咽喉科医が一生に一度経験するかどうかというほど稀な疾患である。中耳癌は耳介・外耳道癌に比較し早期発見が困難であり，治療に関しても進展例では解剖学的な関係から根治手術が行いえない症例が多い。中耳癌に関しては評価しうる化学療法が確立されていない。病変が骨に進展していることが多いため放射線治療に限界があることなどから予後は非常に悪い。われわれは1973年1月から1985年3月の約12年間に中耳の扁平上皮癌を8例経験したので報告する。

　Eight patients with squamous cell carcinoma of the middle ear were presented. The patients consisted of 4 males and 4 females, aged 36-68 years (mean 54 years). Histopathologically, the lesions in 4 patients were of well differentiated type and in 4 patients moderately differentiated type. Regarding to the degree of tumor spread, 3 lesions were early carcinomas and 5 were advanced carcinomas.

　The patients were treated primarily by surgery and radiation therapy. However, multiple combination chemotherapies were conducted in those whom surgery was impossible, and CDDP, THP, and CPA (CTP regimen) showed remarkable effects. Only 2 patients survived for 3 years or longer without recurrence.