鼻咽癌放射治疗失败后手术治疗的有关问题

Relevant Operative Problems After the Failure of NPC Radiation Treatment

目的 通过对本院 1 989～ 1 992年鼻咽癌放射治疗失败后手术治疗 2 3例的回顾性分析 ,探索有关手术适应症 ,手术方法及禁忌症等有关问题。方法 通过鼻咽癌放射治疗后原发灶复发 5例 ,颈淋巴结未控或转移 1 2例 ,颅底侵犯 4例以及颞下颌窝侵犯 2例的手术 ,阐明有关问题。结果 手术后 3年、5年先存率分别为 52 %及 35 % ,手术并发症发生率 7%。随诊死亡 1 2例。远处转移率 52 %。结论 1 .鼻咽癌放射治疗失败后的手术治疗 ,术前必须明确病灶是未控复发、转移或疤痕增生。 2 .手术方式应根据病灶部位及范围选择不同进路及方式进行。 3 .对远处器官转移 。

Objectives: Through reviewing analysis on perations after the failure of NPC radiation treatment the relevant problems of operative indication,operative methods and contraindications were studied.Methods:The relevant problems are explained through taking operations for the uncontrolling or relapse of primary focus,lymphonodi cervicales uncontrolling or relapse and scar hyperplasia after the radiation for NPC is failed.Results: 3 years and 5 years after operation,the survival rate is of 52% and 35% separately.The incidense of operation complication is of 7%. 12 patients died.The rate of metastasizing is of 52%.Summery:1. After the radiation treatment for NPC is failed,the uncontrolled,recurring or scar hyperplasia focus,must be confirmed before the operation.2. The operative methods will be different accoring to the focus location and scope.3. Operative treatment is not suitable for the patients whose distal organs are metastasized and whose basis cranii are destroyed with influence of cerebral parenchyma or cachexia.