: 2

: . .
:
: 966/03

, 2011.
1

......................................................................................3
.........................................................3
......................5
...............................................................6
..............................................9
...............................................10
.................................13
...........................................................................16
.........................................................................17

: phagein - gutati; rinx, ranx - procep, pukotina.

-
, .
,
. , ,
- ,
.
.
:
1. epi - nazofarinks - pars nasalis
2. mezo - orofarinks - pars oralis
3. hipofarinks - pars laryngis

.
.
- , .
.
: ,
.
:
1. :



, .
2.

:
) .
) .
) X, X, X X
:
: 1. - septum
3


longitudinale laminom
prevertebralis 2. stilofaringealna fascija
processus styloideusom i m. stylopharyngeusom.
: ,
.
) lamine medialis processus pterygoideus
) raphe pterygomandibularis
) linea mylohyoidea
)
)
) linea obliqua
) arcusa .
: tuberculum pharyngis

, , .
- cavum pharyngis
1. Pars nasalis
2. Pars oralis
:
)
) ,
)
)
.
,
. ,
.

m. constrictor pharyngis superior.
,
.
:
- fornix pharyngis
.
Tonsilla pharyngea - - Vegetatio adenoides

()

, .
.
,
.
, :

( )
( )
( )

.
"" ()
.
"" ()

.

( ).

.
:
1.
( , . , ).
2.
( ).
5


3. ,
(, .).
.
,
(,. , ).
.
""

().

,
"" .

.
()
()
. .

1 ( )
.
.
2 ( )
3 ( )

,
.

.
, , .
.
( ).
.
6


. 2:1.
50/ .
.

, .
0,3 0,8^/0 .
. :
1. , :
- ,
- (y),
- .
2. ,
3. .
:
- ,
- ,
- .
.
; ,
.
. ,
.
.

, , , .
,
. ,
, , .
-
-
- ;
- (
);
2 - ;
- ;
4 - , .
-
- ;
1 - ;
7


2 - ;
3 - ,
-
- ;
- .

.

, .
: , ,
. : , ,
, , , , , ,
.
, ,
, .

.

.
. ,
,
. :
- ,
- ,
- ,
- ,
- ,
- ,
- .
6 500 7 000 y 6,5 8
. 4 500 5 000 y 5
.
,
.
.
.
.
8


( 192).
, : (
) .

, .
.
.
15/ .

. , , , ,
. , , ,
.
.

:
-

- ( )
-
( : -
-
- . )
-
:
-
-
-
- ()
: (, , , , ):
-
-
- .
: ( 12 )
) :
a) (
1. )
b)
c) (Squamos cell carcinomas)
d) 1. UCNT (Undifferentiated carcinoma of nasopharyngeal type)
9


) :
1)
a.
b.
2) - ( ""
"")

MEZOFARINKS
:
a)
b)
a. -

Lymphoma malignum (
)

HIPOPHARYNX
:

CLINAC 2100C
(Varian, USA). 6 18
6, 9, 12, 16 20.
.

(CLINAC 2100 C, Varian USA; MEVATRON 74, Siemens;
MEVATRON 12, Siemens),
( 6 - 18 ; 6 - 20 ) -
.

10


() MEVASIM S, Siemens,

.
(MEVASIM
S, Siemens) .
(2) (-3) (NPS, Nucletron,
Holandija).

(MICROSELECTRON HDR i
SELECTRON HDR, Nucletron, Holandija) , ,
.

MICROSELECTRON HDR (Nucletron, Holandija) 192-

( 370q) .

(, , ).
50
, 15.000
18.000 . .

. ,
.
.
208 .
, .
, , , -,
, ...
, .
, .
. ,
, .
, ,
. 85
90 , 10 15 .
11


, ( )
(, , ),
. , .
, .
.
, , , ,
. ,
.
.
. ,
. ,
. 40,
.
,
. , ,
,
.
.
.
, . ,
.
43
2006. 48
, 61 ,
. , , 43 .
,
:

12


,
, .

2 .

, ,
.

.
, .

-
.
. .
, . 24 7 .

x
, . ,
,
.

x -,
.
x -, .
1 /.
1 / 1
1 .
:
13


1 = 2,58 X 104 /.
//

.
(y, y);
1y = 1 / (/).
1 y 1
1 . y/.

1 / y
.

- , ,
(). //.
, y/.
,
.

.
.
.
,
,
.

14



( )

( )
( ) .
() .
1 1 000
- .
,
:
(8,25 -1-1 )
= =
() =() / 8,25

, .
.
q.
1 q
1 .

15

; , ,
( x). :
- ,
-
- .

.
:
- ,
- .
( ) :
?
, . ,
. ?
. ,
,
. 30
,
.
,
, .

.
(, ) .
,
,
.

16

:
1. Rosen PP, Groshen S, Saiago PE, et al. Pathological prognostic factors in stage I (T1N0M0) and
stage II (T1N1M0) breast carcinoma: a study of 644 patients
with median follow-up of 18 years. J Clin Oncol 1989; 7: 1239-1251.
2. Stockler M, Wilcken N.R.C, Ghersi D, ym. Systemic reviews of chemotherapy and endocrine
therapy in metastatic breast cancer. Cancer Treat Rev 200; 26:
151-168.
3. Body J-J. Bisphosphonates in breast cancer and other solid tumors. Cancer and the skeleton.
Edit. Rubens R. and Mundy GR. Martin Dunitz Ltd. 2000.pp
231-243.
4. Fossati R, Confalonieri, Torri V, ym. Cytotoxic and hormonal treatment for metastatic breast
cancer, A systematic review of published randomized trials
invoving 31.510 women. J Clin Oncol; vol 16, No 10, 1998: pp 3439-3460.
5. Buzdar AU, Jonat W, Howell A, et al. Anastrozole versus megestro acetate in the treatment of
postmenopausal women with advanced breast carcinoma.
Cancer 1998; 6: 1142-1152.
6. Dombernowsky P, Smith I, Falkson G, et al. Letrozole, a new oral aromatase inhibitor for
advanced breast cancer: Double-blind randomized trial showing a
dose effect and imrpoved efficacy and tolerability compared with megestrol acetate. J Clin
Oncol 1998; 2: 453-461.
7. Nabholtz JM, Buzdar A, Pollak M, et al. Anastrozole is superior to Tamoxifen as first-line
therapy for advanced breast cancer in postmenopausal women:
Results of a North American Multicenter Randomized Trial. J Clin Oncol 2000; 18: 3758-3767.
8. Crump M, Sawka CA, DeBoer G, et al. An individual patient-based meta-analysis of tamoxifen
versus ovarian ablation as first line endocrine therapy for
premenopausal women with metastatic breast cancer. Breast Cancer Res Treat 1997; 44(3):
201-210.
9. Slamon DJ, Leyland-Jones B, Shak S, et al. Use of chemotherapy plus a monoclonal antibody
against HER2 for metastatic breast cancer that over expresses
HER2. N Engl J Med 2001; 344: 783-790.
www..

17