鼻咽癌放疗后鼻咽骨质坏死的病理及治疗现状

Advances in osteoradionecrosis of nasopharynx after radiotherapy for nasopharyngeal carcinoma

鼻咽癌(nasopharyngeal carcinoma,NPC)是我国南方的一种高发性恶性肿瘤,发病率高达(30~50)/10万[1]。放疗是治疗鼻咽癌的主要手段,患者5年总生存率达60%~70%,早期患者5年生存率可达80%以上[2]。然而,鼻咽癌患者受益于放疗的同时,放疗也带来了各种并发症。

Radiation therapy is the first choice for the treatment of nasopharyngeal carcinoma.However,it is inevitable that nasopharyngeal mucosa and tissue will be damaged after radiotherapy of nasopharyngeal carcinoma,which will cause corresponding complications.Nasopharyngeal osteonecrosis is a serious complication.Up to now,there are few reports about nasopharyngeal osteonecrosis,and the underlaying pathological mechanism remains unclear.The potential theories include radiotherapy damage,infection and trauma,but also the "three H" principle of hypoxic-hypocellular-hypovascular tissue,as well as the theory of radio-induced fibrosis.It is controversial about the treatment of nasopharyngeal osteonecrosis.It takes comprehensive treatment,including local treatment,systemic treatment,surgical treatment and other treatments.Among them,local treatment as nasopharyngeal debridement usually is first choice.We reviewed the pathological mechanism and treatment methods of nasopharyngeal osteonecrosis,in order to provide a reference for better prevention and treatment of it.