经鼻内镜挽救性手术治疗局部复发鼻咽癌

鼻咽癌多为低分化鳞状细胞癌,放疗为首选,5年总体生存率可达64.4%〔1〕,约10%左右的患者放疗后局部复发〔2〕。对于复发患者,挽救性放疗或手术治疗成为主要治疗手段。放疗需增加放射剂量,易并发口干、张口困难、听力损伤、放射性骨坏

Endonasal endoscopic salvage surgical treatment for local recurrent nasopharyngeal cancer

Nasopharyngeal cancer is a low differentiated squamous cell carcinoma, and the radiation therapy is the primary choice. It's 5 year survival rate may reach 64.4%, while 10.0% cases may suffer from the local recurrence. The salvage radiation or surgery is still the main choice for recurrent cases now. However the recurrent tumor become radiation insensitive and meanwhile, morbidity and mortality become higher. The experience of open salvage surgery on the recurrent radiation insensitive tumor had been proved safely, and the related morbidity and mortality are acceptable. Recently, the endoscopic salvage surgery has been developed, some preliminary experience has been obtained and the result looks promising. In this article, the pathobiological characteristics of the postradiation local recurrent nasopharyngeal cancer, the anatomy of nasopharyngus and related skull base area, especially the petroclival region and current situation of endonasal endoscopic salvage surgery were reviewed here. Basic principle of oncological surgery that endoscopic surgery should followed and possible endoscopic surgical approaches were proposed.