鼻咽癌放疗后颈淋巴结残留/复发的手术治疗分析

目的：对鼻咽癌放疗后残留／复发颈部转移灶采用手术治疗的疗效。并发症等进行探讨。方法：对31例鼻咽癌放疗后残留颈部转移灶患者进行了手术治疗，术后进行病检了以解颈部转移灶的病理学基础，并进行随访，以确认手术治疗的效果和优缺点，结果：手术治疗的3、5年生存率为65．52％和30．43％、3、5年无瘤生存率为58．63％和30．43％；死亡病例中死于远处转移者10例（52．63％），颈部术后复发者5例（26．32％），鼻咽部复发者4例（21．05％），本组病例未发生严重并发症，术后标本病行病理检查见淋巴结外有大量的孤立肿瘤细胞闭，仅4例患者未见淋巴结外肿瘤细胞，结论：鼻咽癌放疗后残留／复发的颈部转移灶可首选采用手术治疗，术式应采用根治性颈清扫术。

Surgical treatment of residual/recurrent cervical metastasis foci after radiotherapy for nasopharyngeal carcinoma

Objective To study the effects and the complication of surgical treatment of residual /recurrent cervical metastasis foci after radiotherapy for nasopharyngeal carcinoma. Methods 31 cases of residual /recurrent cervical metastasis foci after radiotherapy for nasopharyngeal carcinoma were treated with operation. The resected specimens were sent for pathological study. All ceses were followed up and the effects and the complications were analyzed. Results The 3 and 5-year survival rates were 65.52% and 30.43% respectvely 10 patients died from distant metastasis, 5 patients died from cervical recurrence and 4 patients died from nasopharyngeal recurrence. There was no serious complications found. In most cases many tumor cell masses were seen out of the lymph nodes. Conclusion Radical of neck dissection could be used as the principal treatment for residual /recurrent cervical metastasis foci after radiotherapy for nasopharyngeal carcinoma.