鼻咽癌根治性放疗后残留和复发颈淋巴结的手术治疗远期疗效研究

目的：探讨鼻咽癌根治性放疗后残留和复发的颈部淋巴结手术治疗的疗效及影响因素。方法：1994－1997年住院的68例鼻咽癌根治性放射治疗后有颈部淋巴结残留和复发的患者进行手术治疗，随访进行远期疗效预后分析，并以坟要影响因素进行了初步分析。结果：根治性放疗后颈淋结残留和复发的鼻咽癌患者行手术后的三年、五年局部颈部淋巴结转移复发的控制率（95％CI）分别为30．2－50．2％和20．2－30．4％，淋巴结复发控制的中位时间27月。鼻咽癌根治性放疗后行颈部淋巴结手术治疗术后三年、五年生存率（95％CI）分别为43．1－52．1％和18．1－30％，中位生存时间为32月。颈部淋巴结大小，活动度及手术方式与患者的预后有关（P＜0．05），而性别、年龄及颈部残留与复发与患者生存率无明显差异（P＞0．05）。结论：对根治性放疗术后颈淋结残留和复发的鼻咽癌患者行手术治疗能有效的提高患者的生存率。

The Study of Operation for Recurrence or Residue of Cervical Lymphnode Metastasis in Patients with Nasopharyngeal Carcinoma after Radiotherapy

Objective:To study the effectiveness of operation patients with nasopharyneal carcinomas who had residual or recurrent lymph node metastasis after rediotherapy.Method:Sixty-eight patients in accordance to inclusion and exclusion criteria were studied by case analysis.Results:The three and five year survival rates of the patients with lymph node recurrence or residue(95%CI)were 43.1-52.1% and 18.1-30% respectively,the middle survival time of the patients after operation was 32 months.The size and the moving extent of lymph nodes and the methods of operation had relationship with the survival rate except sex,age and node residue or recurrence.Conclusion:The operation is an effective method to improve the survival rate of nasopharyneal carcinoma with lymphnode residue or recurrence after treatment of radiotherapy.