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背景与目的:了解掌握肿瘤局部浸润扩展的特性、准确判定肿瘤局部侵犯范围,是合理准确地定义和勾画肿瘤放射治疗靶体积的前提和关键。但目前喉咽癌相关的研究仍较少。本研究旨在通过对喉咽癌CT增强扫描结果的分析,探讨喉咽癌局部侵犯扩展的特性及其对治疗的指导意义。方法:回顾性分析2000年8月-2008年9月中山大学肿瘤防治中心收治的65例喉咽癌局部浸润侵犯的CT结果。结果:梨状窝癌(50例)容易侵犯杓会厌皱襞(98%)、喉咽后壁(80%)和同侧会厌(82%)、会厌前间隙(66%)、杓状软骨(74%)、声门旁间隙(82%)、室带(72%)、声带(62%)、甲状软骨板(58%)及口咽侧壁(52%)。咽后壁癌(14例)容易侵犯梨状窝(100%)、杓会厌皱襞(92.9%)、环后区(71.4%)、椎前筋膜(71.4%)及食管(64.3%)。1例环后区癌侵犯梨状窝、喉咽后壁、杓会厌皱襞、杓状软骨、声门旁间隙、环状软骨、甲状软骨及食管。结论:喉咽癌局部浸润扩散的途径和方式主要以直接蔓延侵犯为主,由近及远,与原发癌灶紧邻且局部缺乏组织屏障的组织器官更容易受到侵犯和破坏,未发现跳跃或跨越性侵犯。结果提示放射治疗时常规将鼻咽、颅底作为靶体积进行预防照射似无必要。
BACKGROUND & OBJECTIVE: To understand the characteristics of local invasion and expansion of tumor and accurately determine the extent of local tumor invasion is the prerequisite and key to define and outline the target volume of tumor radiotherapy accurately and accurately. However, the current research on hypopharyngeal carcinoma is still relatively small. This study aimed to analyze the results of CT enhanced scan of hypopharyngeal carcinoma to explore the characteristics of local invasion and expansion of laryngopharyngeal carcinoma and its guiding significance for treatment. Methods: The CT findings of 65 cases of local invasion of hypopharyngeal carcinoma treated by Sun Yat-sen University Cancer Center from August 2000 to September 2008 were retrospectively analyzed. Results: In 50 cases of pyriform sinus cancer, pelvis epiglottis (98%), posterior pharyngeal wall (80%) and ipsilateral epiglottis (82%), anterior epiglottis space (66%), arytenoid cartilage Paravalvacal space (82%), ventricular band (72%), vocal cord (62%), thyroid cartilage plate (58%) and oropharyngeal side wall (52%). Pharyngeal posterior wall cancer (14 cases) easily infested the piriform fossa (92%), posterior annulus (71.4%), prevertebral fascia (71.4%) and esophagus (64.3%). One case of posterior region of the carcinoma invaded pear-shaped fossa, posterior wall of laryngopharynx, laryngeal epiglottis, arytenoid cartilage, glottic space, cricoid cartilage, thyroid cartilage and esophagus. CONCLUSION: The pathways and modes of local invasion and spread of laryngopharyngeal carcinoma are mainly direct invasion and invasion. The tissues and organs adjacent to the primary tumor and the local lack of tissue barrier are more easily infringed and destroyed. Cross sexual assault. The results suggest that conventional radiotherapy nasopharyngeal, skull base as the target volume for prevention of radiation seems unnecessary.