鼻咽癌复发及鼻内镜外科手术的应用

Recurrence of nasopharyngeal carcinoma and application of endoscopic surgery

鼻咽癌传统治疗方式为放射治疗,虽然5年生存率有了较大提高,但依然有不少鼻咽癌复发或残留。复发或残留病灶的处理原则包括再程放疗、化疗和手术治疗。根治性放疗和再程放疗后出现的并发症严重影响了患者生活质量。目前的手术治疗方式有开放式手术和内镜下微创手术,开放式手术可以提供一个足够开放的操作视野,但损伤也较大。内镜下鼻咽癌切除术开展较晚,需要严格的手术适应证、娴熟的内镜颅底外科技术支撑,需要长期的随访观察。

Radiotherapy is the conventional treatment for nasopharyngeal carcinoma. Although the 5-year survival rate has greatly improved, there are still several cases of recurrent or residual nasopharyngeal carcinoma. The treatment principles of recurrent or residual lesions include second-course radiotherapy, chemotherapy, and surgery. The complications following radical radiotherapy and second-course radiotherapy seriously affect the quality of life in patients. The current surgical methods include open surgery and endoscopic surgery. Open surgery can provide a sufficiently open field of operation, but is associated with some serious damage. Endoscopic nasopharyngeal carcinoma resection has been carried out lately, and only few medical institutions in China perform these operations. However, with the emergence of the concept of endoscopic skull base surgery and new medical instruments and equipment, endoscopic nasopharyngeal carcinoma surgery has become a good surgical choice. However, this requires strict surgical indications, skills of endoscopic skull-base surgery, and long-term follow-up.