Wong C S, Cummings B J
Department of Radiation Oncology, Princess Margaret Hospital, Toronto, Ontario, Canada.
Acta Oncol. 1988;27(3):203-8. doi: 10.3109/02841868809093526.
Radiation therapy and limited resection give equally good results in early squamous cell carcinomas of the nasal vestibule, each producing local control rates of 90% or more. For more extensive disease, primary radiation therapy with surgery reserved for residual or recurrent carcinoma is recommended in view of the significant cosmetic defects which generally follow major resection. Small and superficial lesions can be treated by external beam therapy or interstitial implants. Large or infiltrative lesions are best managed by external beam therapy. Serious late morbidity following irradiation is uncommon and has been reported in fewer than 5% of patients. Regional nodal metastases are diagnosed at the time of first presentation in about 5% of patients and signal a very poor prognosis. However, the data available do not support elective treatment of clinically uninvolved regional nodes. Fewer than 5% of patients manifest late nodal metastases when the primary tumor area remains free of recurrence, and most of these metastases can be controlled by neck dissection and/or irradiation.
放射治疗和有限切除对早期鼻前庭鳞状细胞癌的治疗效果相当，局部控制率均达到90%或更高。对于范围更广的病变，鉴于大面积切除通常会导致明显的美容缺陷，建议采用主要针对残留或复发性癌的手术的原发性放射治疗。小而表浅的病变可通过外照射或组织间植入治疗。大的或浸润性病变最好采用外照射治疗。放疗后严重的晚期并发症并不常见，报告发生率低于5%的患者。约5%的患者在首次就诊时被诊断为区域淋巴结转移，这预示着预后很差。然而，现有数据不支持对临床上未受累的区域淋巴结进行选择性治疗。当原发肿瘤区域无复发时，不到5%的患者会出现晚期淋巴结转移，且大多数转移灶可通过颈部清扫和/或放疗得到控制。
