Mantravadi R V
Otolaryngol Clin North Am. 1986 Nov;19(4):741-54.
Recent advances in the understanding of the natural history and modes of spread of the nonsquamous malignancies of the head and neck region have delineated an important role for radiotherapy in their management. The indications for primary radiotherapy include malignant lymphoma of the thyroid, idiopathic midline granuloma, midline malignant reticulosis, extramedullary plasmacytomas, esthesioneuroblastomas, and locally aggressive benign tumors, such as glomus tumors, angiofibromas, and hemangiomas. Although the traditional treatment for malignant melanoma is surgery, indications are emerging for high-dose radiotherapy, either as the only modality or in addition to surgery. Combined radiotherapy and chemotherapy is the treatment choice for nonHodgkin's lymphomas of the Waldeyer's ring and for Ewing's sarcomas. High-grade soft tissue sarcomas and salivary gland malignancies are best treated with surgery and postoperative radiotherapy. The use of megavoltage photons and electrons, custom-made blocks delineating the treatment volume, tissue compensators, patient immobilization devices, and simulator-aided treatment planning are mandatory to achieve loco-regional control and to minimize the treatment-related morbidity.
对头颈部非鳞状恶性肿瘤自然史及扩散方式认识的最新进展，已明确放射治疗在其治疗中发挥着重要作用。原发性放射治疗的适应证包括甲状腺恶性淋巴瘤、特发性中线肉芽肿、中线恶性网状细胞增多症、髓外浆细胞瘤、嗅神经母细胞瘤，以及局部侵袭性良性肿瘤，如球瘤、血管纤维瘤和血管瘤。尽管恶性黑色素瘤的传统治疗方法是手术，但高剂量放射治疗作为唯一治疗方式或联合手术的适应证也逐渐显现。放射治疗与化疗联合是治疗Waldeyer环非霍奇金淋巴瘤和尤因肉瘤的选择。高度恶性软组织肉瘤和涎腺恶性肿瘤最好采用手术及术后放射治疗。为实现局部区域控制并将治疗相关的发病率降至最低，必须使用兆伏级光子和电子、定制的描绘治疗体积的铅挡块、组织补偿器、患者固定装置以及模拟机辅助治疗计划。
