Zhang Zong-min, Xu Zhen-gang, Liu Shao-yan, Wang Xiao-lei, Wu Yue-huang, Qi Yong-fa
Department of Head and Neck Surgery, Cancer Institute (Hospital), Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2012 Jun;47(6):462-5.
To study salvage surgery for persistent or recurrent nasopharyngeal carcinoma after irradiation failure.
A total of 84 cases underwent salvage surgery for persistent or recurrent nasopharyngeal carcinoma after irradiation failure between 1993 and 2009 was reviewed. rTNM stage: rT1 34 cases, rT2 27 cases, rT3 12 cases and rT4 11 cases; rN0 70 cases, rN1 9 cases and rN2 5 cases; No with distance metastatic. The salvage surgeries were performed using maxillary swing approach (47 cases), transcervical-mandibulo-palatal approach (21 cases), palate nasopharyngectomy (6 cases), lateral rhinotomy (7 cases), and maxillectomy (3 cases).
Persistent or recurrent nasopharyngeal carcinoma after irradiation failure was resected completely in 57 patients (67.9%) and there were microscopic residual diseases in 27 patients (32.1%). The median follow-up was 27 months. Postoperative recurrence occurred in 35 cases. Thirty-six patients died of recurrence, metastasis and other diseases. The overall 5 year survival rate was 43.6%. Cox regression analysis indicated the complete resection for persistent or recurrent disease and no cervical metastasis were two independent factors affecting survival.
Salvage surgery for persistent or recurrent nasopharyngeal carcinoma after irradiation failure is an effective treatment.
研究放疗失败后持续性或复发性鼻咽癌的挽救性手术。
回顾性分析1993年至2009年间84例行放疗失败后持续性或复发性鼻咽癌挽救性手术的患者。rTNM分期：rT1 34例，rT2 27例，rT3 12例，rT4 11例；rN0 70例，rN1 9例，rN2 5例；均无远处转移。挽救性手术采用上颌骨摆动入路（47例）、经颈-下颌-腭入路（21例）、腭部鼻咽癌切除术（6例）、鼻侧切开术（7例）和上颌骨切除术（3例）。
57例（67.9%）放疗失败后的持续性或复发性鼻咽癌患者实现了完全切除，27例（32.1%）有镜下残留病灶。中位随访时间为27个月。术后35例复发。36例患者死于复发、转移及其他疾病。总体5年生存率为43.6%。Cox回归分析表明，持续性或复发性疾病的完全切除及无颈部转移是影响生存的两个独立因素。
放疗失败后持续性或复发性鼻咽癌的挽救性手术是一种有效的治疗方法。
