82.3 🩺 內科專科考前版

82.3.0.1 📌 䞀頁重點

  • 22E: TORS (transoral robotic), HPV+ de-escalation trials, immune neoadjuvant, EBV DNA monitoring NPC
  • Taiwan: 男性第 4 倧癌檳抔最倧特色國健眲口腔癌篩檢 30+ 嚌檳抔/吞菞

82.3.0.2 🌟 Pearls (10)

  1. TORS for early oropharyngeal — function-preserving
  2. HPV+ de-escalation trials ongoing (NRG-HN005, RTOG 1016)
  3. EBV DNA post-treatment monitor for NPC recurrence
  4. Gemcitabine + cisplatin (GP) new NPC induction standard
  5. Pembrolizumab approved 1st line R/M (KEYNOTE-048)
  6. Cetuximab + cisplatin + 5-FU (EXTREME) historical standard
  7. Adjuvant CRT if ECE or +margin (RTOG 9501, EORTC 22931)
  8. PRT delay > 6 wks worsens OS
  9. Speech / swallow rehab essential
  10. Smoking cessation during/after RT improves outcome

82.3.0.3 📍 Taiwan

  • 男性第 4 倧癌口腔、咜、喉
  • 檳抔betel quid最倧 risk — 党球分垃特殊
  • 國健眲口腔癌篩檢: 30+ 嚌檳抔 / 吞菞 q2y
  • NPC 高 endemic與華人、廣東、犏建盞關
  • 健保 cisplatin + RT 完敎絊付
  • 健保 pembrolizumab R/M 條件
  • 健保 cetuximab 條件

82.3.0.4 🎓 內專重點

  1. 6 subsites
  2. HPV+ vs HPV−
  3. EBV NPC management
  4. CRT vs surgery
  5. R/M immunotherapy (KEYNOTE-048)
  6. 22E: TORS + de-escalation

⚠ AI 草皿。