Department of Head and Neck Surgery, Military General Hospital of Beijing, Dongshiliutiao Road, Beijing, China.
Int J Clin Oncol. 2012 Jun;17(3):212-7. doi: 10.1007/s10147-011-0276-5. Epub 2011 Jun 29.
Nasopharyngeal carcinoma is sensitive to radiotherapy. When there is local relapse, re-irradiation treatment is inevitably associated with serious complications and decreased quality of life. Surgical resection offers an alternative treatment option with acceptable morbidity.
Seventy-one consecutive patients with primary recurrence of nasopharyngeal carcinoma after radiation underwent nasopharyngectomy from January 1, 1990 to June 30, 2006. Follow-up ranged from 12 to 127 months.
The actuarial 1-, 2-, 3-, and 5-year survival rates were 88.1, 62.1, 48.9, and 42.1%, respectively. The 1-, 2-, 3-, and 5-year local control rates were 74.6, 61.9, 56.3, and 53.5%, respectively. There was no surgical mortality. The 3-year overall survival rates for recurrent T1, T2, T3, and T4 disease after surgery were 56, 61.1, 30.6, and 0%, respectively; the corresponding 5-year overall survival rates were 49.1, 24.7, 0, and 0%, respectively. Other prognostic factors with a negative effect on survival include lymph node metastasis, invasion of skull base and parapharyngeal space, and positive margin.
Advances in skull base surgery make possible the effective control of primary recurrence of nasopharyngeal carcinoma for patients with rT1 and rT2 stages, with acceptable mortality and morbidity.
鼻咽癌对放疗敏感。局部复发时，再放疗不可避免地会引起严重并发症，降低生活质量。手术切除提供了一种可接受的发病率的替代治疗选择。
1990 年 1 月 1 日至 2006 年 6 月 30 日，71 例原发性鼻咽癌放疗后复发患者行鼻咽切除术。随访时间为 12 至 127 个月。
actuarial 1 年、2 年、3 年和 5 年生存率分别为 88.1%、62.1%、48.9%和 42.1%。1 年、2 年、3 年和 5 年局部控制率分别为 74.6%、61.9%、56.3%和 53.5%。无手术死亡。术后复发 T1、T2、T3 和 T4 疾病的 3 年总生存率分别为 56%、61.1%、30.6%和 0%；相应的 5 年总生存率分别为 49.1%、24.7%、0%和 0%。对生存有负面影响的其他预后因素包括淋巴结转移、颅底和咽旁间隙侵犯以及切缘阳性。
颅底外科的进步使 rT1 和 rT2 期患者的原发性鼻咽癌复发得到有效控制，死亡率和发病率均可接受。
