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本文引用的文献

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The management of neck metastases in nasopharyngeal cancer.鼻咽癌颈部转移灶的处理
Curr Opin Otolaryngol Head Neck Surg. 2007 Apr;15(2):99-102. doi: 10.1097/MOO.0b013e3280148a06.
2
Extraction of metastatic lymph nodes from MR images using two deformable model-based approaches.使用两种基于可变形模型的方法从磁共振图像中提取转移性淋巴结。
J Digit Imaging. 2007 Dec;20(4):336-46. doi: 10.1007/s10278-006-1037-2.
3
Nasopharyngeal carcinoma.鼻咽癌
Ear Nose Throat J. 2005 Jul;84(7):404-5.
4
Target dose conformity in 3-dimensional conformal radiotherapy and intensity modulated radiotherapy.三维适形放疗和调强放疗中的靶区剂量适形度
Radiother Oncol. 2004 May;71(2):201-6. doi: 10.1016/j.radonc.2004.03.004.
5
Intensity-modulated radiotherapy in nasopharyngeal carcinoma: dosimetric advantage over conventional plans and feasibility of dose escalation.鼻咽癌调强放射治疗:与传统计划相比的剂量学优势及剂量递增的可行性
Int J Radiat Oncol Biol Phys. 2003 May 1;56(1):145-57. doi: 10.1016/s0360-3016(03)00075-0.
6
Nasopharyngeal carcinoma: presenting symptoms and duration before diagnosis.鼻咽癌:诊断前的症状表现及持续时间。
Hong Kong Med J. 1997 Dec;3(4):355-361.
7
Management of extensive cervical nodal metastasis in nasopharyngeal carcinoma after radiotherapy: a clinicopathological study.鼻咽癌放疗后广泛性颈部淋巴结转移的管理:一项临床病理研究
Arch Otolaryngol Head Neck Surg. 2001 Dec;127(12):1457-62. doi: 10.1001/archotol.127.12.1457.
8
Nodal volume reduction after concurrent chemo- and radiotherapy: correlation between initial CT and histopathologic findings.同步放化疗后淋巴结体积缩小:初始CT与组织病理学结果之间的相关性
AJNR Am J Neuroradiol. 2000 Feb;21(2):310-4.
9
Nasopharyngeal cancer.鼻咽癌
Hematol Oncol Clin North Am. 1999 Aug;13(4):837-47. doi: 10.1016/s0889-8588(05)70096-4.
10
Prognostic factors of nasopharynx tumors investigated by MR imaging and the value of MR imaging in the newly published TNM staging.磁共振成像研究鼻咽癌的预后因素及磁共振成像在新发布的TNM分期中的价值。
Int J Radiat Oncol Biol Phys. 1999 Jan 15;43(2):273-8. doi: 10.1016/s0360-3016(98)00417-9.

挽救性手术治疗鼻咽癌颈部残留或复发:10 年经验。

Salvage surgery for neck residue or recurrence of nasopharyngeal carcinoma: a 10-year experience.

机构信息

Department of Head and Neck Surgery, Fudan University Cancer Hospital, Shanghai, People's Republic of China.

出版信息

Ann Surg Oncol. 2011 Jan;18(1):233-8. doi: 10.1245/s10434-010-1292-9. Epub 2010 Aug 25.

DOI:10.1245/s10434-010-1292-9
PMID:20737217
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3018243/
Abstract

BACKGROUND

To assess the outcome of and determine prognostic factors for neck residue or recurrence of nasopharyngeal carcinoma (NPC) in patients treated with a salvage neck dissection.

MATERIALS AND METHODS

Over a 10-year period (from January 1998 through December 2007) in a tertiary hospital, we systematically reviewed the clinical charts of 355 patients with NPC who were diagnosed with neck residue or recurrence of nasopharyngeal carcinoma, after radical definitive radiotherapy with or without chemotherapy.

RESULTS

The group with recurrent nodal disease consisted of 285 patients (80.3%), while the group with residual nodal disease included 70 patients (19.7%). There were no patients died of the surgery complications. Overall survival (OS), disease-free survival (DFS), and disease-specific survival (DSS) were 54.11, 35.01, and 55.59%, respectively, at 3-year, and 26.03, 22.65, and 27.84%, respectively, at 5-year. The local control rate in the neck was 70.92% at 3 years and 60.98% at 5 years. For all the 3 survival outcomes (OS, DFS, and DSS) and the local control rate of disease in the neck, there were significant differences between the "residue group" and "recurrence group."

CONCLUSIONS

Radical neck dissection is proven to be safe and effective in the treatment of the neck failure. Our study has demonstrated that it may be possible to choose the selective lymph node dissection for patients of the residue group.

摘要

背景

评估挽救性颈清扫术后残留或复发鼻咽癌(NPC)患者的结局,并确定其预后因素。

材料与方法

在一家三级医院,我们回顾性分析了 1998 年 1 月至 2007 年 12 月间接受根治性放化疗后出现 NPC 颈部残留或复发的 355 例患者的临床资料。

结果

复发淋巴结组 285 例(80.3%),残留淋巴结组 70 例(19.7%)。无手术相关死亡病例。3 年总体生存率(OS)、无病生存率(DFS)和疾病特异性生存率(DSS)分别为 54.11%、35.01%和 55.59%,5 年 OS、DFS 和 DSS 分别为 26.03%、22.65%和 27.84%。3 年时颈部局部控制率为 70.92%,5 年时为 60.98%。所有 3 项生存结局(OS、DFS 和 DSS)和颈部疾病局部控制率在“残留组”和“复发组”之间差异均有统计学意义。

结论

根治性颈清扫术治疗颈部失败安全有效,本研究表明对于残留组患者可以选择选择性淋巴结清扫术。