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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 5 0 0 0 % (7/ 14)、5 7 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。
Objective: To explore the main surgical treatment of nasopharyngeal carcinoma and improve the quality of life of patients. Methods: According to the clinical staging criteria of nasopharyngeal carcinoma, there were 14 cases of nasopharyngeal carcinoma without nasal skull base invasion and distal metastasis (3 of them were uncontrollable radiotherapy). There were 6 cases in stage Ⅰ, 3 cases in stage Ⅱ, 3 cases in stage Ⅲ Cases, the main operation, intraoperative freezing, postoperative radiotherapy and / or chemotherapy supplemented by a comprehensive treatment. Among the 14 cases, 10 cases were treated by palatal approach, including 7 cases with soft and hard palate tongue-shaped incision, tongue-shaped tip pointing uvula, 3 cases with soft and hard palate vertical incision incision, and 4 cases with nasal incision surgery. Results: 14 cases were observed 1 to 5 years, no recurrence of nasopharyngeal carcinoma. The 5-year, 3-year and 1-year survival rates were 5 0 0% (7/14), 5 7 14% (8/14) and 92 86% (13/14), respectively. One of the patients died of pulmonary metastases after surgery. Conclusion: The main operation of comprehensive treatment of nasopharyngeal carcinoma is feasible and effective. Because there is no recurrence of nasopharyngeal carcinoma, without repeated radiotherapy, to prevent the complications of repeated radiotherapy to improve the quality of life of patients.