目的：針對下咽癌接受單獨性放射線治療或手術合併術後放射線治療，評估其治療結果，並分析組織學上之預後因子。 材料與方法：自 1987 年 1 月至 1997 年 12 月，在本院接受單獨性放射線治療或手術合併術後放射線治療的 81 位下咽癌病患，作回溯性的分析，其中男性占 79 位，女性 2 位，年齡介於 24 至 80 歲 (中間值 54)。 其腫瘤第一期至四期分別為 0，3，22 及 56 位，這兩組病患之 T-- 期與 N-- 期分佈上並無明顯差異，其中18 位病患接受單獨性放射線治療， 每天 1.8Gy，放射線治療之平均劑量為 63.9 Gy (介於34.2 至 75.6 Gy)，另外 63 位病患接受全喉切除術合併部分咽喉切除或食道切除術，這些病患皆接受輔助性放射線治療，平均劑量為 60.4Gy( 介於 36 至 73.8Gy)。 結果：接受手術合併術後放射線治療之病患的 5 年存活率為 33%，接受單獨性放射線治療病患的 5 年存活率為 30%，這兩組存活率無明顯差異。 接受手術合併術後放射線治療之病患的 5 年局部控制率為 52%， 而接受單獨性放射線治療病患的 5 年局部控制率為 40%，其有統計學上差異 (p=0.015)。多因子分析確認神經侵犯與壞死為重要的預後因子。結論：手術合併術後放射線治療比單獨性放射線治療有較好的局部控制率，但對存活率無明顯差異，神經侵犯與壞死為有意義之預後因子。

　　　　　Purpose:To evaluate treatment results and analyze pathologicalprognostic factors in surgery plus postoperative radiotherapy and radiotherapyalone for hypopharyngeal cancer. Materials and Methods:This retrospectiveanalysis is based on the clinical outcome of 81 patients with hypopharyngealcancer treated with surgery plus adjuvant radiotherapy and radiotherapy alonefrom January 1987 to December 1997. There were 79 males and 2 females, between24 and 80 years old (median:54). The numbers of patients in stages Ⅰ to Ⅳ were0,3,22 and 56, respectively. There were no significant difference in T-andN-distributions between the two treatment groups. Radiotherapy alone was used in18 patients with 1.8 Gy pen fraction per day to a mean total dose of 63.9 Gy(range 34.2 to 75.6 Gy). Surgical treatment for 63 patients consisted of totallaryngectomy with partial or total pharyngectomy and esophagectomy whenindicated. These patients received adjuvant radiotherapy to a mean dose of 60.4Gy(rang 36 to 73.8 Gy). Results:The 5-year survival rates were 33% for patientstreated with surgery plus adjuvant radiotherapy and 30% for patients treatedwith radiotherapy alone. There was no significant difference in survival betweenthe two treatment groups. The local control rate at 5 years was 52% for patientstreated with surgery plus adjuvant radiotherapy, compared with 40% for patientstreated with radiotherapy alone with a significant difference (p=0.015).Multivariate analysis identified that perineural invasion and necrosis are thesignificant predictors of poorer survival. Conclusion:The combination of surgeryplus radiotherapy results in a better locoregional control than radiotherapyalone, but dose not yield a better survival. Perineural invasion and necrosisare associated with poorer survival.