经鼻内镜下使用磷酸钛钾（KTP）激光切除早期局部复发性鼻咽癌

Endoscopic nasopharyngectomy with potassium-titanyl-phosphate (KTP) laser for early locally recurrent nasopharyngeal carcinoma.

作者信息

Ko Jenq-Yuh, Wang Cheng-Ping, Ting Lai-Lei, Yang Tsung-Lin, Tan Ching-Ting

机构信息

Department of Otolaryngology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.

出版信息

Head Neck. 2009 Oct;31(10):1309-15. doi: 10.1002/hed.21091.

DOI:10.1002/hed.21091

PMID:19360738

Abstract

BACKGROUND

Although early recurrent nasopharyngeal carcinoma (NPC) can be treated with surgery alone, conventional nasopharyngectomy still results in serious complications. Endoscopic nasopharyngectomy has been introduced, but data on the treatment outcomes of this technique are lacking.

METHODS

From March 2004 to December 2007, 28 patients with rT1 or rT2a NPC underwent potassium-titanyl-phosphate (KTP) laser nasopharyngectomy by endoscopic techniques with curative intent.

RESULTS

Twenty-five patients underwent surgery alone. Only 3 patients received postoperative adjuvant therapy. The 2-year local disease-free and 2-year overall survival rates for the 12 patients with rT1 tumor and for the 16 patients with rT2a tumor were 100% and 41.7% (p = .007); and 90.9% and 38.5% (p = .03), respectively. Only 3 patients had obvious osteonecrosis at the nasopharynx, and 1 patient developed hypoglossal nerve dysfunction.

CONCLUSIONS

Endoscopic KTP laser nasopharyngectomy is a simple, safe, and successful procedure for treating rT1 NPC, though its benefits are less clear for rT2a.

摘要

背景

尽管早期复发性鼻咽癌（NPC）可单独通过手术治疗，但传统的鼻咽癌切除术仍会导致严重并发症。内镜下鼻咽癌切除术已被引入，但缺乏关于该技术治疗效果的数据。

方法

2004年3月至2007年12月，28例rT1或rT2a期鼻咽癌患者接受了经内镜技术的磷酸钛钾（KTP）激光鼻咽癌切除术，目的是根治。

结果

25例患者仅接受了手术。只有3例患者接受了术后辅助治疗。12例rT1期肿瘤患者和16例rT2a期肿瘤患者的2年局部无病生存率和2年总生存率分别为100%和41.7%（p = 0.007）；以及90.9%和38.5%（p = 0.03）。只有3例患者鼻咽部出现明显骨坏死，1例患者出现舌下神经功能障碍。