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口咽癌

HPV可以引致口咽癌,由HPV-16型病毒引起的口咽癌佔全部HPV引起的口咽癌至少85%1
根據中大醫學院的研究,數據顯示平均約每5名香港口咽癌患者就有1人感染HPV2。他們相對其他非HPV口咽癌患者年輕,較多為非吸煙或非酗酒人士2
根據香港醫院管理局癌症資料統計中心,於2020年共有116宗口咽癌新症3。當中,有92名為男患者,佔全部的79%。由此可見口咽癌的發病率以男士較高3,4

口咽癌病徵

口咽癌的病徵和其他頭頸癌症狀相似。最常見的口咽癌病徵是口腔、咽喉或頭、頸部出現的潰瘍或腫塊,數周都沒有康復5。之後患者或會出現吞嚥困難或咳血等症狀5。口咽癌患者或會有無法解釋的喉嚨疼痛和耳朵疼痛5

口咽癌治療

醫生會根據病人癌症的期數來制定適合的口咽癌治療,包括放射治療、外科手術5,6。外科手術一般適合於早期的口咽癌6。接受口咽癌手術治療後,患者有機會出現各種副作用,例如吞嚥和咀嚼困難、呼吸和言語障礙等7。放射治療可單獨用作治療手段和輔助治療,以減少癌症復發6。口咽癌患者接受放射性治療後,可能會感到疲倦、皮膚發紅、口腔潰瘍、口乾等副作用8。上述情況有機會在結束治療後時間慢慢改善8

口咽癌存活率

由HPV引起的口咽癌的潛伏期可以長達10-30年9。口咽癌的5年存活率約有60%10。而且,HPV相關的口咽癌比無關的口咽癌能有較好的預後和存活率,因為HPV相關的口咽癌患者多為年輕和較健康的族群10

預防口咽癌

儘管並非所有的口咽癌都可以預防,但如果採取適當的預防措施,例如:保持健康的體重和飲食習慣、遠離煙酒,還是可以降低患上口腔癌的風險。11,12。除此以外,定期進行牙齒檢查也可以幫助患者及早發現口腔癌,牙醫可能會在常規口腔檢查中發現癌前病變的跡象12


References: 1. Lechner M, et al. Nat Rev Clin Oncol. 2022;19(5):306–27. 2. Lam EW, et al. Cancer Epidemiol Biomarkers Prev. 2016;25(1):165-173. 3. Hong Kong Cancer Registry. Hong Kong Cancer Statistics. Tonsil, oropharynx cancers (total cases). Available at: https://www3.ha.org.hk/cancereg/allagesresult.asp. Accessed on: 23 Feb 2023. 4. Hong Kong Cancer Registry. Hong Kong Cancer Statistics. Tonsil, oropharynx cancers (men). Available at: https://www3.ha.org.hk/cancereg/allagesresult.asp. Accessed on: 23 Feb 2023. 5. National Cancer Institute. Oropharyngeal Cancer Treatment (Adult) (PDQ®)-Patient Version. Available at: https://www.cancer.gov/types/head-and-neck/patient/adult/oropharyngeal-treatment-pdq. Accessed 23 Feb 2023. 6. Cancer Research UK. Treatment options for mouth and oropharyngeal cancer. Available at: https://www.cancerresearchuk.org/about-cancer/mouth-cancer/treatment/treatment-decisions .Accessed on: 23 Feb 2023. 7. Cancer Research UK. Types of surgery. Available at: https://www.cancerresearchuk.org/about-cancer/mouth-cancer/treatment/surgery/types-surgery. Accessed 23 Feb 2023. 8. Cancer Research UK. Side effects of radiotherapy for mouth and oropharyngeal cancer. Available at: https://www.cancerresearchuk.org/about-cancer/mouth-cancer/treatment/radiotherapy/side-effects . Accessed 23 Feb 2023. 9. Gillison ML, et al. J Clin Oncol. 2015;33(29): 3235–42. 10. Jamal Z, Anjum F. Oropharyngeal Squamous Cell Carcinoma. [Updated 2022 Sep 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK563268/ 11. American Cancer Society. Can Oral Cavity and Oropharyngeal Cancers Be Prevented? Available at: https://www.cancer.org/cancer/oral-cavity-and-oropharyngeal-cancer/causes-risks-prevention/prevention.html. Accessed on: 07 Mar 2023. 12. American Society of Clinical Oncology Cancer.Net. Oral and Oropharyngeal Cancer: Risk Factors and Prevention. Available at: https://www.cancer.net/cancer-types/oral-and-oropharyngeal-cancer/risk-factors-and-prevention. Accessed on: 07 Mar 2023.


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