鼻咽癌放疗后颈淋巴结残留或复发的手术治疗

Salvage surgery for residual or recurrent cervical lymphnode of nasopharygeal carcinoma after radiotherapy

目的 探讨颈淋巴结清扫术治疗鼻咽癌放疗后颈淋巴结残留或复发的应用价值及效果。方法 对36例鼻咽癌放疗后颈淋巴结残留或复发的患者行颈淋巴结清扫术 ,应用Kaplan -Meier法计算颈部局控率和总生存率 ,对影响生存率的有关因素采用Cox模型进行分析。结果 术后 3年、5年颈部局部控制率为 4 4 1%和 2 3 5 % ,3年、5年总生存率为 4 7%和 2 6 4 %。多因素分析结果表明 :颈淋巴结≥ 3cm、淋巴结包膜外侵者预后差。结论 颈淋巴结清扫术是治疗鼻咽癌放疗后颈淋巴结残留或复发的有效方法 ,能明显提高患者的颈部局控率及总生存率。颈淋巴结大小。

Objective To explore the value of radical neck dissection in the treatment of patients who had residual or recurrent cervical lymph node of nasopharygeal carcinoma after radiotherapy.Methods Thirty six patients who had residual or recurrent cervical lymph node of nasopharygeal carcinoma after radiotherapy underwent radical neck dissection.The cumulative suriival rate was analyzed by Kaplan-Meier method.The factors were compared using the log-rank test.The influencing factors were screened by Cox proportional hazards model.Results The overall 3 and 5 year survival rates were 47.0% and 26.4%.The 3 and 4 year local control rates were 44.1% and 23.5%,respectively.Multivariate analysis showed that the lymph node size≥3cm and the involvement of the capsule of the lymph node were independently associated with decreased survival rates(P<0.05).Conclusion The radical neck dissection is an effective method in improving the survival rate.The lymph node size and the involvement of the capsule of the lymph node are independent factors affecting the prognosis.