原发灶不明的颈部转移癌91例临床分析

Study of metastatic carcinoma in neck from unknown primary foci(report of 91 cases)

自1971年3月～1985年7月共收治经病理证实的原发灶不明颈转移癌91例。其中男性67例(73.6%),女性24例(26.4%)。平均50.9岁(14～73岁)。主要症状为颈部无痛性肿块。主要治疗方法有:(1)颈廓清术组33例;(2)颈部放疗组40例;(3)面颈联合野放疗组18例。总的疗效:3、5、10年生存率分别为44.0%、39.6%、21%。颈廓清术组、颈部放疗组及面颈联合野放疗组的5年生存率分别为39.4%、35%、50%,照射剂量以 DT6000～9000cGy 为宜。笔者认为:中上颈部淋巴结转移癌大部分来自鼻咽、口咽等器官,应用面颈联合野行根治性放疗为首选治疗方法,5年生存率可达到50%。

91 cases with metastatic neoplasms in neck from unknown primary foci were treated in our hospital from March 1971 to July 1985.Of them 67(73.6%)were male and 24(26.4%)females with a sex ratio(M:F)of 2.8:1 and an average age of 50.9.The primary symptom was a painless mass in the neck.The predominant therapeutic modalities were as follow:radical neck node dissection(group 1);simple radiotherapy in neck(group 2);radiotherapy both in the neck and face(group 3).The overall 3,5,10 year survival rates were 44,39.6 and 22.0% respectively. The 5 year survival rate was 39.4% in group 1,35.0% in group 2,and 50.0% in group 3.The recommendable irradiation dosage should be 6000～9000 cGy/6～9w.The authors beleive that radio- therapy in the neck and the face is a fairly satisfactory therapeutic modality against metastatic carcinoma from unknown origen,as its 5 year survival rate was as high as 50%.The prog- nostic factors of metastatic carcinoma in the neck from unknown primary tumor is discussed with a review of literature.