TNM. Interpretation on Clinical Guide of Head and Neck Cancer NCCN, 2010 Edition CHEN Xiao-zhong NCCN. T2b( NCCN. 6cm. T4a. T4b NCCN 2009.

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1 NCCN 2010 Interpretation on Clinical Guide of Head and Neck Cancer NCCN 2010 Edition CHEN Xiao-zhong ( ) :2010 NCCN 2009 : ; ;NCCN :R :A : X(2010) NCCN : 6 T2a( / ) 7 T1 T2b( ) 7 T2(T2 a NCCN b) :N1 / 6cm ; :T3 T4a : T4b NCCN 2010 :T3 ( T4a) T4a 1 AJCC 7 TNM :T4a T4b T4a T4b : :T4a T4b T4a ;T4b T4a TNM T4a :T4a T4b ( ) ( ) N ( ) [ ( 1.4 ( )TNM ) ( ( ) ] T4b 1.5 TNM 1.2 ( )TNM : T4b 1.3 TNM T4a T4b T4a T4b 511

2 Journal of Oncology2010Vol.16No TNM T3: T4a: 2010 T4b: IMRT [2~6] ( ) NX: N0: N1: 60Gy 44~64Gy(1.6~2.0Gy/ ) (IMRT) 4 / (3 ) 2 T1N1~3;T2~T4 N 2010 NCCN T3 N0 T1~2 N+ T3 N ⑴ ( 3.1 :1 ):1 + 66Gy ( 70Gy 70Gy ) 2A 1 [7~9] 2A 66~74Gy / [10] Bonner ; 70Gy Gy ~74Gy 44~64Gy Gy(2.0Gy/d) 44~64Gy % 36.4% (1.6~2.0Gy/ ) [1] / (2B ) 3.2 [11] 5-Fu/ / : 60Gy /5-Fu /5-Fu 60~66Gy 50Gy(2.0Gy/ [12~14] 2 d) 44~64Gy(1.6~2.0Gy/ ) 1 [15~17] 3 / 3.3 / /5-Fu 1 [18~20] 2 70Gy(2.0Gy/d) 44~ (TAX323 TAX324 ) 512

3 : ⑶ 1 : [21] 1 ⑵ [26] / /5-Fu 2A ⑷ 1 [22] ⑶ : ( ) : +5-Fu± 2~3cm ; +5-Fu+ (1 ) [23] Extreme / (SCCHN) : 442 / ( 2 SCCHN 220 ( ) 3cm 5-Fu 222 ( ) 5-Fu )60~66Gy(2.0Gy/ ) (20% vs 50~60Gy(2.0Gy/ ) 36%) (7.4 vs 10.1 ) 46% [2425] +5-Fu 5 2~3cm 6 NCCN NCCN :1 2 : 3 (HMB-45 S-100 Melan-A) 7 :(1) : :⑴ : ;T4a N0 (2) : ;T3~4a N1 (3) : + ; b c (4) : ⑵ (5) : : (6) ; a + ( ) : ; b c 513

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