CAJ | 학술논문

目的：研究鼻咽癌放疗后颈部淋巴结残留或复发行挽救手术治疗的疗效及影响预后的因素，探讨其合理的治疗方法。方法：回顾性分析2001-2009年行挽救手术治疗的鼻咽癌放疗后颈部淋巴失败患者39例的临床资料。重新评价手术标本的病理参数及肿瘤TNM分期。分析其总生存率和颈部控制情况及相关临床病理因素。结果：全组3年、5年总生存率（ OS）为63.6％、53.4％，3年、5年颈部控制率（ NCR ）为77.1％、70.0％。鼻咽癌初始治疗采用单纯放疗组OS优于同步放化疗组；rN1组OS和NCR均优于rN2/3组。复发N分期是影响OS和NCR的唯一独立因素。结论：颈清扫术是鼻咽癌放疗后颈部淋巴结失败的有效治疗手段。初始治疗方法、复发N分期与生存预后相关。复发N分期是预后的独立因素。
목적：연구비인암방료후경부림파결잔류혹복발행만구수술치료적료효급영향예후적인소，탐토기합리적치료방법。방법：회고성분석2001-2009년행만구수술치료적비인암방료후경부림파실패환자39례적림상자료。중신평개수술표본적병리삼수급종류TNM분기。분석기총생존솔화경부공제정황급상관림상병리인소。결과：전조3년、5년총생존솔（ OS）위63.6％、53.4％，3년、5년경부공제솔（ NCR ）위77.1％、70.0％。비인암초시치료채용단순방료조OS우우동보방화료조；rN1조OS화NCR균우우rN2/3조。복발N분기시영향OS화NCR적유일독립인소。결론：경청소술시비인암방료후경부림파결실패적유효치료수단。초시치료방법、복발N분기여생존예후상관。복발N분기시예후적독립인소。
Objective:To reveal the treatment outcome and prognostic predictors of salvage surgery for residual or recurrent cervical metastasis of nasopharyngeal carcinoma after radiotherapy,as well as to explore an optimal treatment modality. Methods:Clinical data of 39 patients who underwent salvage neck dissections for their residual or recurrent cervical metastases after radiotherapy for nasopharyngeal carcinoma were retrospectively analyzed. Pathological param-eters of the surgical specimen and TNM classification were re -evaluated. Overall survival( OS),neck control rate (NCR),and their correlated patho-clinical factors were analyzed. Results:The 3-year and 5-year OS was 63. 6%and 53. 4%,respectively,the 3 -year and 5 -year NCR was 77. 1% and 70. 0%,respectively. Survival status was better in patients who underwent single radiotherapy as initial treatment for nasopharyngeal carcinoma than in patients who underwent concomitant chemo-radiotherapy. OS and NCR of the rN1 group were better than that of the rN2/3 group. rN stage was the only independent predictor for both OS and NCR. Conclusion:Neck dissection is an effica-cious salvage procedure for neck failure of nasopharyngeal carcinoma after radiotherapy. Initial treatment modality and rN stage were associated with survival in univariate analysis. rN stage was the only independent prognostic factor.