Hu Kenneth, Persky Mark S
Albert Einstein College of Medicine, Beth Israel Medical Center, New York, New York, USA.
Oncology (Williston Park). 2003 Aug;17(8):1143-53; discussion 1154, 1158, 1161.
Paragangliomas most commonly occur in the carotid body, jugulotympanic area, and vagus nerve but have also been reported in other areas of the head and neck. These tumors are highly vascular and characteristically have early blood vessel and neural involvement, making their treatment particularly challenging. Surgery has traditionally been the preferred method of treatment, especially in light of recent advances in technique. However, compared to radiation therapy, it can result in a higher incidence of cranial nerve dysfunction. Radiation therapy has the advantage of avoiding the increased morbidity of surgery while offering an equal possibility of cure. Part 2 of this article discusses radiation therapy as primary treatment of patients who are ineligible for surgery and the elderly and infirm. Results with radiotherapy are comparable to those achieved with surgery. The efficacy of salvage therapy with either surgery or radiation is discussed, and a treatment algorithm for these tumors is proposed.
副神经节瘤最常发生于颈动脉体、颈鼓区和迷走神经，但也有在头颈部其他区域的报道。这些肿瘤血管丰富，其特征是早期就有血管和神经受累，这使得它们的治疗极具挑战性。传统上，手术一直是首选的治疗方法，尤其是鉴于最近技术上的进展。然而，与放射治疗相比，手术会导致更高的颅神经功能障碍发生率。放射治疗的优势在于避免了手术带来的更高发病率，同时提供了同等的治愈可能性。本文的第二部分讨论了放射治疗作为对不适合手术的患者以及老年体弱患者的主要治疗方法。放射治疗的结果与手术治疗相当。文中还讨论了手术或放射挽救治疗的疗效，并提出了针对这些肿瘤的治疗方案。
