Maisel R H, Manivel J C, Porto D P, Stanley M
Ear Nose Throat J. 1989 Sep;68(9):684-6, 696-8, 700-1.
We discuss four cases of postirradiation sarcomas of the head and neck. Two cases were metachronous sarcomas that appeared after operation and irradiation for primary sarcomas, 1 case was a mandibular malignant fibrous histiocytoma that developed on the opposite side of the jaw from a malignant histiocytic neoplasm that was irradiated 8 years previously, and 1 case was a laryngeal tumor that appeared 5 years after combined operative and radiation therapy for a laryngeal squamous carcinoma. Immunohistochemical studies more precisely defined and classified these tumors, and assisted in determining a therapeutic protocol. The therapy for postirradiation sarcomas includes extirpative operation when possible, but the role of chemotherapy is uncertain. The aggressive behavior of these neoplasms was attested to by the death of three patients within 18 months of their operations.
我们讨论了4例头颈部放疗后肉瘤。2例为异时性肉瘤,出现在原发性肉瘤手术和放疗之后;1例为下颌骨恶性纤维组织细胞瘤,发生于8年前接受放疗的颌骨恶性组织细胞瘤的对侧;1例为喉肿瘤,在喉鳞状细胞癌手术及放疗联合治疗5年后出现。免疫组化研究更精确地界定和分类了这些肿瘤,并有助于确定治疗方案。放疗后肉瘤的治疗包括尽可能进行根治性手术,但化疗的作用尚不确定。3例患者在术后18个月内死亡,证明了这些肿瘤的侵袭性。