鼻内镜手术治疗首诊局部晚期鼻咽癌及放疗后严重并发症的作用
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摘要
随着鼻内镜技术的不断提高,其已逐渐成为鼻咽癌综合治疗中的重要方式之一。就首诊局部晚期鼻咽癌的手术治疗、鼻咽癌放疗后严重并发症放射性骨坏死的内镜手术治疗及内镜手术在未来鼻咽癌治疗中可能的发展前景等方面进行综述。
With the improvement in endoscopic techniques, endoscopy has gradually become an important approach for the comprehensive treatment of nasopharyngeal carcinoma. This article reviews the literature on the surgical treatment of locally advanced nasopharyngeal carcinoma and the endoscopic surgical treatment of radioactive necrosis, a severe complication of radiotherapy for nasopharyngeal carcinoma. Prospects for the development of future endoscopic surgery techniques for nasopharyngeal carcinoma have also been reviewed.
With the improvement in endoscopic techniques, endoscopy has gradually become an important approach for the comprehensive treatment of nasopharyngeal carcinoma. This article reviews the literature on the surgical treatment of locally advanced nasopharyngeal carcinoma and the endoscopic surgical treatment of radioactive necrosis, a severe complication of radiotherapy for nasopharyngeal carcinoma. Prospects for the development of future endoscopic surgery techniques for nasopharyngeal carcinoma have also been reviewed.
引文
[1]Chen MK,Lai JC,Chang CC,et al.Minimally invasive endoscopic nasopharyngectomy in the treatment of recurrent T1-2a nasopharyngeal carcinoma[J].Laryngoscope,2007,117(5):894-896.doi:10.1097/MLG.0b013e3180381644.
[2]黄波,司勇锋.鼻咽癌原发灶残留或复发的鼻内镜手术治疗[J].中国临床新医学,2015,8(2):174-177.doi:10.3969/j.issn.1674-3806.2015.02.26.HUANG Bo,SI Yongfeng.The nasal endoscopic surgery in residual or recurrence of primary focal nasopharyngeal carcinoma[J].Chinese Journal of New Clinical M edicine,2015,8(2):174-177.doi:10.3969/j.issn.1674-3806.2015.02.26.
[3]Yoshizaki T,Wakisaka N,Murono S,et al.Endoscopic nasopharyngectomy for patients w ith recurrent nasopharyngeal carcinoma at the primary site[J].Laryngoscope,2005,115(8):1517-1519.doi:10.1097/01.M LG.0000165383.35100.17.
[4]陈明远,郭翔,文卫平,等.局限性残留、复发鼻咽癌的鼻内镜进路救援性外科治疗[J].癌症(英文版),2007,26(7):673-678.CHEN M ingyuan,GUO Xiang,WEN Weiping,et al.Salvage surgical operation via endoscopic transnasal approach for local persistent or recurrent nasopharyngeal carcinoma[J].Chinese Journal of Cancer,2007,26(7):673-678.
[5]Chen MY,Wen WP,Guo X,et al.Endoscopic nasopharyngectomy for locally recurrent nasopharyngeal carcinoma[J].The Laryngoscope,2009,119(3):516-522.doi:10.1002/lary.20133.
[6]张维天,郭金宝,殷善开.经鼻内镜挽救性手术治疗局部复发鼻咽癌[J].临床耳鼻咽喉头颈外科杂志,2012(12):572-576.ZHANG Weitian,GUO Jinbao,YIN Shankai.Endonasal endoscopic salvage surgical treatment for local recurrent nasopharyngeal cancer[J].Journal of Clinical Otorhinolaryngology,2012(12):572-576.
[7]孙希才,刘娟,王欢,等.内镜下复发性鼻咽癌71例切除及预后分析[J].中华耳鼻咽喉头颈外科杂志,2015,50(11):890-895.doi:10.3760/cma.j.issn.1673-0860.2015.11.003.SUN Xicai,LIU Juan,WANG Huan,et al.Endoscopic nasopharyngectomy for recurrent nasopharyngeal carcinoma:a review of 71 patients and analysis of the prognostic factors[J].Chinese Journal of Otorhinolaryngology Head and Neck Surgery,2015,50(11):890-895.doi:10.3760/cma.j.issn.1673-0860.2015.11.003.
[8]陈卓,邱前辉.内镜手术治疗鼻咽癌残留或复发的临床疗效及生活质量分析[J].中华耳鼻咽喉头颈外科杂志,2015,50(11):896-903.doi:10.3760/cma.j.issn.1673-0860.2015.11.004.CHEN Zhuo,QIU Qianhui.Analysis of clinical efficacy and the quality of life after endoscopic nasopharyngectomy for residual or recurrent nasopharyngeal carcinoma[J].Chinese Journal of Otorhinolaryngology Head and Neck Surgery,2015,50(11):896-903.doi:10.3760/cma.j.issn.1673-0860.2015.11.004.
[9]Huang Y,Qiu QH.Endoscopic surgery for early-stage nasopharyngeal carcinoma:a justified initial option[J].Acta Otolaryngol,2017,137(11):1194-1198.doi:10.1080/00016489.2017.1351041.
[10]粘家斌,邱前辉.鼻咽癌放疗后残留或复发不同r T分级的内镜挽救性手术特点分析[J].临床耳鼻咽喉头颈外科杂志,2016,30(6):459-463.doi:10.13201/j.issn.1001-1781.2016.06.010.NIAN Jiabin,QIU Qianhui.Analysis of the characteristics of salvage endoscopic surgery for residual or recurrent nasopharyngeal carcinoma w ith different r T grading after radiotherapy[J].Journal of Clinical Otorhinolaryngology Head and Neck Surgery,2016,30(6):459-463.doi:10.13201/j.issn.1001-1781.2016.06.010.
[11]Wu Z,Su Y,Zeng RF,et al.Prognostic value of tumor volume for patients w ith nasopharyngeal carcinoma treated w ith concurrent chemotherapy and intensity-modulated radiotherapy[J].J Cancer Res Clin Oncol,2014,140(1):69-76.doi:10.1007/s00432-013-1542-x.
[12]邱前辉,李娜,张秋航,等.内镜手术治疗首诊局部晚期鼻咽癌的疗效分析[J].中华耳鼻咽喉头颈外科杂志,2017,52(5):365-371.QIU Qianhui,LI Na,ZHANG Qiuhang,et al.Clinical efficacy of endoscopic nasopharyngectomy for initially diagnosed advanced nasopharyngeal carcinoma[J].Chinese Journal of Otorhinolaryngology Head and Neck Surgery,2017,52(5):365-371.
[13]O'Dell K,Sinha U.Osteoradionecrosis[J].Oral Maxillofac Surg Clin North Am,2011,23(3):455-464.doi:10.1016/j.coms.2011.04.011.
[14]Lee CC,Ho CY.Post-treatment late complications of nasopharyngeal carcinoma[J].Eur Arch Otorhinolaryngol,2012,269(11):2401-2409.doi:10.1007/s00405-011-1922-2.
[15]Tuan JKL,Ha TC,Ong WS,et al.Late toxicities after conventional radiation therapy alone for nasopharyngeal carcinoma[J].Radiotherapy and Oncology,2012,104(3):305-311.doi:10.1016/j.radonc.2011.12.028.
[16]Chang KP,Tsang NM,Chen CY,et al.Endoscopic management of skull base osteoradionecrosis[J].Laryngoscope,2000,110(7):1162-1165.doi:10.1097/00005537-200007000-00018.
[17]黄晓明,郑亿庆,麦海强,等.鼻咽癌放射治疗后颅底骨坏死的诊断和治疗[J].中华耳鼻咽喉科杂志,2004,39(9):558-561.doi:10.3760/j.issn:1673-0860.2004.09.013.HUANG Xiaoming,ZHENG Yiqing,M AI Haiqiang,et al.Diagnosis and treatment on osteoradionecrosis of skull base after radiotherapy for nasopharyngeal carcinoma[J].Chinese Journal of Otorhinolaryngology,2004,39(9):558-561.doi:10.3760/j.issn:1673-0860.2004.09.013.
[18]陈卓,邱前辉,粘家斌,等.鼻咽癌放疗后大范围颅底骨坏死的内镜手术处理及颅底重建原则[J].中华耳鼻咽喉头颈外科杂志,2016,51(12):881-886.CHEN Zhuo,QIU Qianhui,NIAN Jiabin,et al.Endoscopic surgery and reconstruction for extensive osteoradionecrosis of skull base after radiotherapy for nasopharyngeal carcinoma[J].Chinese JOurnal of Otorhinolaryngology Head and Neck Surgery,2016,51(12):881-886.
[19]张维天,殷善开.内镜下带血管蒂鼻中隔黏骨膜瓣修复颅底缺损[J].中华耳鼻咽喉头颈外科杂志,2011,46(6):463-468.doi:10.3760/cma.j.issn.1673-0860.2011.06.006.ZHANG Weitian,YIN Shankai.An endoscopic approach to reconstruction of skull base defects using a vascular pedicled nasoseptal mucoperiosteal flap[J].Chinese Journal of Otorhinolaryngology Head and Neck Surgery,2011,46(6):463-468.doi:10.3760/cma.j.issn.1673-0860.2011.06.006.
[20]Kassam A,Snyderman CH,Mintz A,et al.Expanded endonasal approach:the rostrocaudal axis.Part I.Crista galli to the sella turcica[J].Neurosurg Focus,2005,19(1):E3.
[21]Snyderman CH,Kassam AB,Carrau R,et al.Endoscopic reconstruction of cranial base defects follow ing endonasal skull base surgery[J].Skull Base,2007,17(1):73-78.
[2]黄波,司勇锋.鼻咽癌原发灶残留或复发的鼻内镜手术治疗[J].中国临床新医学,2015,8(2):174-177.doi:10.3969/j.issn.1674-3806.2015.02.26.HUANG Bo,SI Yongfeng.The nasal endoscopic surgery in residual or recurrence of primary focal nasopharyngeal carcinoma[J].Chinese Journal of New Clinical M edicine,2015,8(2):174-177.doi:10.3969/j.issn.1674-3806.2015.02.26.
[3]Yoshizaki T,Wakisaka N,Murono S,et al.Endoscopic nasopharyngectomy for patients w ith recurrent nasopharyngeal carcinoma at the primary site[J].Laryngoscope,2005,115(8):1517-1519.doi:10.1097/01.M LG.0000165383.35100.17.
[4]陈明远,郭翔,文卫平,等.局限性残留、复发鼻咽癌的鼻内镜进路救援性外科治疗[J].癌症(英文版),2007,26(7):673-678.CHEN M ingyuan,GUO Xiang,WEN Weiping,et al.Salvage surgical operation via endoscopic transnasal approach for local persistent or recurrent nasopharyngeal carcinoma[J].Chinese Journal of Cancer,2007,26(7):673-678.
[5]Chen MY,Wen WP,Guo X,et al.Endoscopic nasopharyngectomy for locally recurrent nasopharyngeal carcinoma[J].The Laryngoscope,2009,119(3):516-522.doi:10.1002/lary.20133.
[6]张维天,郭金宝,殷善开.经鼻内镜挽救性手术治疗局部复发鼻咽癌[J].临床耳鼻咽喉头颈外科杂志,2012(12):572-576.ZHANG Weitian,GUO Jinbao,YIN Shankai.Endonasal endoscopic salvage surgical treatment for local recurrent nasopharyngeal cancer[J].Journal of Clinical Otorhinolaryngology,2012(12):572-576.
[7]孙希才,刘娟,王欢,等.内镜下复发性鼻咽癌71例切除及预后分析[J].中华耳鼻咽喉头颈外科杂志,2015,50(11):890-895.doi:10.3760/cma.j.issn.1673-0860.2015.11.003.SUN Xicai,LIU Juan,WANG Huan,et al.Endoscopic nasopharyngectomy for recurrent nasopharyngeal carcinoma:a review of 71 patients and analysis of the prognostic factors[J].Chinese Journal of Otorhinolaryngology Head and Neck Surgery,2015,50(11):890-895.doi:10.3760/cma.j.issn.1673-0860.2015.11.003.
[8]陈卓,邱前辉.内镜手术治疗鼻咽癌残留或复发的临床疗效及生活质量分析[J].中华耳鼻咽喉头颈外科杂志,2015,50(11):896-903.doi:10.3760/cma.j.issn.1673-0860.2015.11.004.CHEN Zhuo,QIU Qianhui.Analysis of clinical efficacy and the quality of life after endoscopic nasopharyngectomy for residual or recurrent nasopharyngeal carcinoma[J].Chinese Journal of Otorhinolaryngology Head and Neck Surgery,2015,50(11):896-903.doi:10.3760/cma.j.issn.1673-0860.2015.11.004.
[9]Huang Y,Qiu QH.Endoscopic surgery for early-stage nasopharyngeal carcinoma:a justified initial option[J].Acta Otolaryngol,2017,137(11):1194-1198.doi:10.1080/00016489.2017.1351041.
[10]粘家斌,邱前辉.鼻咽癌放疗后残留或复发不同r T分级的内镜挽救性手术特点分析[J].临床耳鼻咽喉头颈外科杂志,2016,30(6):459-463.doi:10.13201/j.issn.1001-1781.2016.06.010.NIAN Jiabin,QIU Qianhui.Analysis of the characteristics of salvage endoscopic surgery for residual or recurrent nasopharyngeal carcinoma w ith different r T grading after radiotherapy[J].Journal of Clinical Otorhinolaryngology Head and Neck Surgery,2016,30(6):459-463.doi:10.13201/j.issn.1001-1781.2016.06.010.
[11]Wu Z,Su Y,Zeng RF,et al.Prognostic value of tumor volume for patients w ith nasopharyngeal carcinoma treated w ith concurrent chemotherapy and intensity-modulated radiotherapy[J].J Cancer Res Clin Oncol,2014,140(1):69-76.doi:10.1007/s00432-013-1542-x.
[12]邱前辉,李娜,张秋航,等.内镜手术治疗首诊局部晚期鼻咽癌的疗效分析[J].中华耳鼻咽喉头颈外科杂志,2017,52(5):365-371.QIU Qianhui,LI Na,ZHANG Qiuhang,et al.Clinical efficacy of endoscopic nasopharyngectomy for initially diagnosed advanced nasopharyngeal carcinoma[J].Chinese Journal of Otorhinolaryngology Head and Neck Surgery,2017,52(5):365-371.
[13]O'Dell K,Sinha U.Osteoradionecrosis[J].Oral Maxillofac Surg Clin North Am,2011,23(3):455-464.doi:10.1016/j.coms.2011.04.011.
[14]Lee CC,Ho CY.Post-treatment late complications of nasopharyngeal carcinoma[J].Eur Arch Otorhinolaryngol,2012,269(11):2401-2409.doi:10.1007/s00405-011-1922-2.
[15]Tuan JKL,Ha TC,Ong WS,et al.Late toxicities after conventional radiation therapy alone for nasopharyngeal carcinoma[J].Radiotherapy and Oncology,2012,104(3):305-311.doi:10.1016/j.radonc.2011.12.028.
[16]Chang KP,Tsang NM,Chen CY,et al.Endoscopic management of skull base osteoradionecrosis[J].Laryngoscope,2000,110(7):1162-1165.doi:10.1097/00005537-200007000-00018.
[17]黄晓明,郑亿庆,麦海强,等.鼻咽癌放射治疗后颅底骨坏死的诊断和治疗[J].中华耳鼻咽喉科杂志,2004,39(9):558-561.doi:10.3760/j.issn:1673-0860.2004.09.013.HUANG Xiaoming,ZHENG Yiqing,M AI Haiqiang,et al.Diagnosis and treatment on osteoradionecrosis of skull base after radiotherapy for nasopharyngeal carcinoma[J].Chinese Journal of Otorhinolaryngology,2004,39(9):558-561.doi:10.3760/j.issn:1673-0860.2004.09.013.
[18]陈卓,邱前辉,粘家斌,等.鼻咽癌放疗后大范围颅底骨坏死的内镜手术处理及颅底重建原则[J].中华耳鼻咽喉头颈外科杂志,2016,51(12):881-886.CHEN Zhuo,QIU Qianhui,NIAN Jiabin,et al.Endoscopic surgery and reconstruction for extensive osteoradionecrosis of skull base after radiotherapy for nasopharyngeal carcinoma[J].Chinese JOurnal of Otorhinolaryngology Head and Neck Surgery,2016,51(12):881-886.
[19]张维天,殷善开.内镜下带血管蒂鼻中隔黏骨膜瓣修复颅底缺损[J].中华耳鼻咽喉头颈外科杂志,2011,46(6):463-468.doi:10.3760/cma.j.issn.1673-0860.2011.06.006.ZHANG Weitian,YIN Shankai.An endoscopic approach to reconstruction of skull base defects using a vascular pedicled nasoseptal mucoperiosteal flap[J].Chinese Journal of Otorhinolaryngology Head and Neck Surgery,2011,46(6):463-468.doi:10.3760/cma.j.issn.1673-0860.2011.06.006.
[20]Kassam A,Snyderman CH,Mintz A,et al.Expanded endonasal approach:the rostrocaudal axis.Part I.Crista galli to the sella turcica[J].Neurosurg Focus,2005,19(1):E3.
[21]Snyderman CH,Kassam AB,Carrau R,et al.Endoscopic reconstruction of cranial base defects follow ing endonasal skull base surgery[J].Skull Base,2007,17(1):73-78.