鼻咽癌放疗后颌面多原发癌的临床特点

目的 总结鼻咽癌放疗后颌面部多原发癌的治疗经验。方法 回顾11例鼻咽癌放疗术后口腔颌面部出现多原发癌患者的临床资料。结果 鼻咽癌放疗后口腔颌面部多原发癌患者因开口受限影响麻醉与手术视野，手术有一定难度；解剖层次不清，易损伤血管神经；局部组织再生能力低下影响伤口的愈合和皮瓣的生长；组织缺损大，需远处肌皮瓣转移修复；本组例发生的多原发癌多数为高分化鳞癌，手术和再次放疗后，平均随访5．7年，死于指示肿瘤和第二肿瘤的死亡率为45．5％。结论 鼻咽癌放疗后口腔颌面部多原发癌的治疗难度大，远期疗效不佳。

The Clinical Characteristics of Maxillofacial Multiple Primary Carcinoma with Nasopharyngeal Carcinoma

Objective To study the clinical characteristics of maxillofacial multiple primary carcinoma with nasopharyngeal carcinoma(NPC) after radiotherapy.Methods 11 patients with maxillofacial multiple primary carcinomas after NPC radiotherapy were reviewed . Results Because of radioactive trismus and the narrow visual field of operation, the surgery on these patients was difficult. With neck tissues conglutination ,the blood vessels and nerves were easy to be injured .As the regeneration ability of radiolesion tissue was lower,the neck flap was easy to necrosis, and the large defect should be reconstruction used pectoralis major myocutaneous flap . The second primary carcinoma in this group was main high degree differentiation squamous cell carcinoma , on average 5.7 years follow-up ,for second primary carcinoma the group mortality rate was 18.2 % (2/11),for index tumor and second tumor was 45.5 %(5/11). Conclusion The operation on oral and maxillofacial multiple primary carcinomas with NPC after radiotherpy may be difficulty,and the long-dated effect is not obvious .