| 鼻咽癌放疗后颈淋巴结复发再治疗临床分析 |
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| 引用本文： | 唐 秋, 胡巧英. 鼻咽癌放疗后颈淋巴结复发再治疗临床分析[J]. 中国肿瘤临床, 2010, 37(1): 13-15. DOI: 10.3969/j.issn.1000-8179.2010.01.004 |
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| 作者姓名： | 唐秋 胡巧英 |
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| 作者单位： | 浙江省肿瘤医院放疗科(杭州市310022 ) |
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| 摘 要： | 目的：探讨鼻咽癌放疗后颈部复发治疗疗效及影响预后的因素。方法：回顾性分析鼻咽癌根治性放疗后颈部复发再治疗的82例患者临床资料，其中rN1 期26例，rN2 期18例，rN3 期38例。按患者性别、放射治疗结束至复发之日的间隔时间、rN分期、复发部位、治疗方式、治疗结束时疗效分为2 组；手术治疗组按淋巴结外受累情况、淋巴结转移数、颈清术范围分为2 个亚组。生存率分析采用Kaplan-Meier 法，差异显著性检验采用Log-rank 法，多因素分析采用COX 模型。结果：82例颈淋巴结复发再程治疗后1、3、5 年局部控制率分别为58.0% 、39.0% 、39.0% ；1、3、5 年生存率分别为82.9% 、47.6% 、25.0% 。以放疗为主治疗组1、3、5 年生存率分别为80.8% 、37.1% 、19.1% ；以手术为主治疗组1、3、5 年生存率分别为86.7% 、66.0% 、34.2% 。以手术为主治疗疗效优于以放疗为主的治疗。其预后因素与肿瘤复发部位有关。结论：鼻咽癌放疗后颈淋巴结复发再治疗的疗效较满意，治疗应选择以颈清术为主的综合治疗。
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| 关 键 词： | 鼻咽肿瘤 放射疗法 颈淋巴结清扫术 |
| 收稿时间： | 2009-10-11 |
| 修稿时间： | 2009-12-02 |
Analysis of Re-treatment for Cervical Lymph Node Recurrence in Nasopharyngeal Carcinoma Patients after Radiotherapy |
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| TANG Qiu, HU Qiaoying. Analysis of Re-treatment for Cervical Lymph Node Recurrence in Nasopharyngeal Carcinoma Patients after Radiotherapy[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2010, 37(1): 13-15. DOI: 10.3969/j.issn.1000-8179.2010.01.004 |
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| Authors: | TANG Qiu HU Qiaoying |
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| Affiliation: | Department of Radiation Oncology, Zhejiang Province Cancer Hospital , Hangzhou 310022, China |
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| Abstract: | Objective:To investigate the efficacy of re-treatment for cervical lymph node recurrence in nasopharyngeal carcinoma patients after radiotherapy and to explore the prognostic factors.Methods:Eighty-two patients who received therapy due to cervical lymph node recurrence after deftnitive radiotherapy were reviewed.The relevant factors including sex.the interval between radiotherapy and recurrence,rN stage,recurrence site,treatment modalities,and treatment efficacy were analyzed.Subgroup analysis was performed to review the relevant factors including the involvement in the adjacent tissues,the number of positive nodes and surgical range.Kaplan-Meier method,Log-rank test and Cox method were used for statistical analysis.Results:The 1-,3-and 5-year local control rates were 58%,39.0%,and 39.0%,respectively.The 1-,3-and 5-year overall survival rates were 82.9%,47.6%.and 25.0%,respectively.The 1-,3-and 5-year overall survival rates in the radiotherapy-based treatment group were 80.8%,37.1%and 19.1%,respectively.The 1-,3-and 5-year overall survival rates in the surgery-based treatment group were 86.7%,66% and 34.2%,respectively.The efficacy of surgery-based treatment was superior to that of radiotherapy-based treatment.In the multivariate analysis,tumor recurrence site was an independent prognostic factor.Conclusion:Radical neck dissection-based treatment can achieve satisfactory efficacy for cervical lymph node recurrence after radiotherapy in nasopharyngeal carcinoma patients. |
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| Keywords: | Nasopharyngeal neoplasm Radiotherapy Radical neck dissection |
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