鼻咽癌放疗后颈部残留灶不同处理方法的结果分析

Analysis of Theraputic Effect of Various Treatment for the Residual Neck Metastasis of NPC After Radiotherapy

为了探讨鼻咽癌放疗后颈部残留灶的最佳处理方法，收集了１９８６年１２月至１９９１年１２月１０５例资料完整的鼻咽癌放疗后颈部残留灶病例资料。１５例行手术治疗，术后颈部复发率，局部控制率，５ａ生存率分别为６．７％，９３．４％，５３．３％，术后病理诊断阳性率为４０．０％。２７例行化学治疗，总有效率及５ａ生存率分别为３７．０％，３３．３％。手术治疗与化学治疗的５ａ生存率比较，差异无显著性，Ｐ＞０．０５。６３例继续观察，６个月内颈残留灶完全消退患者与未消退者５ａ生存率分别为４２．５％和１３．０％，差异有显著性，Ｐ＜０．０５。鼻咽癌放疗后颈部残留灶应密切随访观察，如未消退则应积极采取补救措施，首选手术治疗，能完全消退者则不影响其５ａ生存率。

To explore the best treatment for the residual neck metastasis of NPC after radiotherapy,writer collected the complete data of 105 patients from December 1986 to December 1991.15 patients were operated,the neck recurrence rates,the local control rates,the 5 year survival rates were 6.7%,93.4% and 53.3% respectively.After operation,40.0% patients had cancer cells residual.27 patients accepted chemotherapy,the overall effective rates,the 5 year survival rates were 37.0% and 33.3% respectively.There was no significant difference between operation and chemotherapy group in 5 year survival rate( P >0.05).63 patients were observed,the 5 year survival rates in neck residual resolved completely and nonresolved were 42.5% and 13.0% respectively( P <0.05).Conclusion:the residual neck metastasis of NPC after radio therapy must be observed,if the residual couldn′t resolved,the salvage treatment will be necessary,and operation would be the first choice.