下咽癌治疗的研究进展

Research Progress on the Treatment of Hypopharyngeal Cancer

摘要: 下咽癌在解剖学上下咽包括侧咽、后咽壁、梨状窝和通向食管入口的环状后区。在临床实践中，下咽癌经常出现在晚期，严重影响了患者的生活质量。尽管头颈部癌症的整体肿瘤学治疗取得了进展，但下咽癌的预后仍相对较差，多年来生存率仅略有改善。下咽癌近50%的患者在诊断后的第一年内复发，且多为远处转移。下咽癌的可用治疗方案包括手术、放疗或化疗，具体取决于临床阶段和共病情况。下咽癌症的治疗仍然是一个挑战，需要多学科的方法来制定最佳治疗方案。总体目标是优化存活率，并在从肿瘤学角度看可行时提供功能性器官保存。本文围绕下咽癌治疗，基于证据的治疗方案进行全面综述，特别关注器官保留模式的演变。

Abstract: Hypopharyngeal cancer anatomically includes the lateral pharynx, the posterior pharyngeal wall, the pyriform fossa and the posterior cricoid region leading to the entrance of the esophagus. In clin-ical practice, hypopharyngeal cancer is frequently seen in advanced stages, which severely affects the quality of life of patients. Despite advances in the overall oncologic treatment of head and neck cancers, the prognosis for hypopharyngeal cancer remains relatively poor, with only modest im-provements in survival over the years. Nearly 50% of patients with hypopharyngeal cancer recur within the first year of diagnosis, and most have distant metastases. Available treatment options for hypopharyngeal cancer include surgery, radiation therapy or chemotherapy, depending on the clinical stage and co-morbidities. The treatment of hypopharyngeal cancer remains a challenge and requires a multidisciplinary approach to develop optimal treatment options. The overall goal is to optimize survival and provide functional organ preservation when feasible from an oncologic per-spective. This article provides a comprehensive review of evidence-based treatment options around hypopharyngeal cancer treatment, with a particular focus on the evolution of organ preservation paradigms.