张玉庚 杨宝琦 杨硕郎 林鹏 阮宏莹 张玉庚(天津市第一中心医院耳鼻喉科天津市耳鼻喉科研究所 天津市300192)；杨宝琦(天津市第一中心医院耳鼻喉科天津市耳鼻喉科研究所 天津市300192)；杨硕郎(天津市第一中心医院耳鼻喉科天津市耳鼻喉科研究所 天津市300192)；林鹏(天津市第一中心医院耳鼻喉科天津市耳鼻喉科研究所 天津市300192)；阮宏莹(天津市第一中心医院耳鼻喉科天津市耳鼻喉科研究所 天津市300192) 中国肿瘤临床 2000 0 27 5


    关键词：鼻咽癌；外科手术；综合治疗 期刊 zgzllc 0 论著 fur -->


    

摘要 目的：探讨手术为主综合治疗鼻咽癌，提高患 者的生存质量。方法：选取无颅底骨侵犯和远端转 移的鼻咽癌14例(其中3例是放疗不能控制者)，按鼻 咽癌临床分期标准，Ⅰ期6例，Ⅱ期3例，Ⅲ期5例，行 手术为主、术中冷冻、术后放疗和(或)化疗为辅的综 合治疗。14例中10例采用经腭进路手术，其中7例采用 软硬腭舌形切口，舌形的尖端指向悬雍垂，3例采用 软硬腭垂直裂开切口；4例采用鼻侧切开入路手术。 结果：14例分别观察1～5年，未见鼻咽癌复发。其5年 、3年和1年生存率分别为50.00%(7/14)、57.14%(8/14) 和92.86%(13/14)。其中1例术后因肺转移癌死亡。结论 ：手术为主综合治疗鼻咽癌是可行的、有效的。因 无鼻咽癌复发，无须重复放疗，可防止重复放疗的 并发症，提高患者的生存质量。

Surgery as Predominant Therapy for Comprehensive Treatment of Nasopharyngeal Cancer

Zhang Yugeng Yang Baoqi Yang Shuolang
(Department of ENT, Tianjin First Central Hospital, Tianjin)

Abstract Objective: To improve the living quality of patients with nasopharyngeal cancer (NPC) by surgery as the predominant therapy. Methods: Fourteen patients with NPC without involvement of skull base or metastasis were treated by surgery as the predominant therapy of comprehensive treatment (three of them were not radiosensitive). According to the criteria of clinical stage of NPC: Stage Ⅰ was 6 cases, Stage Ⅱ 3 cases and Stage Ⅲ 5 cases. The comprehensive treatment consisted of frozen therapy, postoperative radiation, chemotherapy and operation as the predominant management. In the overall patients, 10 cases underwent transpalatal operation (a tongue- form incision of the soft- hard palate with the tip of the incision toward uvula was performed on 7 cases, and a vertical split incision of soft- hard palate was made on 3 cases) and lateral rhinotomy approach was performed on other 4 cases. Results: After 1 to 5 year follow- up, no recurrence was observed. The 1- , 3- and 5- year survival rates of these patients were 92.86% (13/14), 57.14% (8/14) and 50.00% (7/14) respectively. One of them died of postoperative lung metastasis. Conclusion: Surgery as the predominant therapy of comprehensive treatment of NPC is feasible and effective. There is no recurrence or repeated radiotherapy and its complications so that the patient will have a better living quality.
Key Words Nasopharyngeal carcinoma Surgery Comprehensive treatment

鼻咽癌常规首选治疗方法是放疗^[1] ......

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