鼻内镜手术为主的鼻腔鼻窦恶性肿瘤的治疗

Treatment of malignant sinonasal tumoursbased onendoscopic endonasal surgery

鼻腔鼻窦恶性肿瘤最初无明显临床表现，当进展到—定大小和范围时才引起重视，故多半患者确诊时已发展到中晚期。单一手术治疗对中晚期肿瘤的疗效不佳；而单一放疗，除极少对放射线特别敏感的肉瘤和未分化癌外，治疗效果远不如手术治疗。传统的方法是先放疗后手术或先手术后放疗，较单一手术治疗的生存率有明显提升。近年来经鼻内镜手术切除鼻腔鼻窦恶性肿瘤的安全有效性越来越受到认可，本文旨在对以鼻内镜手术为主辅以合理的放化疗的治疗进展做总结。

Malignant tumors of nasal cavity and paranasal sinus begin with no obvious clinical manifestations. Patients paid attention to them when the tumors reach a certain size and range, so most of the patients have advanced to the middle and late stage. Single surgical treatment is not effective in the treatment of middle and advanced stage tumors, while radiotherapy alone is far less effective than surgical treatment. Radiotherapy only take effect on few highly sensitive sarcomas and undifferentiated carcinomas. The traditional method is radiotherapy before surgery, or postoperative radiotherapy, and the survival rate has been significantly improved. In recent years, the safety and effectiveness of endoscopic sinus surgery for nasal and paranasal sinus malignant tumors have been increasingly recognized. This article aims to summarize the progress of endoscopic sinus surgery supplemented by reasonable chemoradiotherapy.