鼻咽癌复发及鼻内镜外科手术的应用

姜彦

Recurrence of nasopharyngeal carcinoma and application of endoscopic surgery

Yan JIANG

图6 患者男，38岁，分化型非角化癌(T3N0M0)。先内镜下手术切除，术后放化疗(DT：7 623 cGy/33f，仅25次；3 675 cGy/15f；TP：多西他赛140 mg d1+奈达铂140 mg dl)，随访48个月 A-D.术前MR显示：鼻咽癌组织侵犯蝶窦、鞍区，推挤视交叉上抬，患者视力下降；E-H.术后24个月显示鼻咽癌病灶无复发；I.术中切除包绕颈内动脉骨管的肿瘤组织(白色箭头所指为颈内动脉)；J.术中切除视神经骨管表面的肿瘤组织(白色箭头所指为视交叉)；K.放化疗后鼻咽部外观，局部有干痂；L.随访24个月时鼻咽部外观，干痂少。

Fig.6 A 38-year-old man with differentiated non-keratinized carcinoma (T3N0M0) underwent endoscopic surgical resection, postoperative radiotherapy, and chemotherapy (DT: 7 623 cGy/33 f, only 25 times; 3 675 cGy/15 f; TP: docetaxel 140 mg/dl + nedaplatin 140 mg/dl), with follow-up for 48 months A-D. Preoperative magnetic resonance (MR) shows that nasopharyngeal carcinoma tissue invaded the sphenoid sinus and saddle region, pushing up on the optic chiasm, causing impaired vision in the patient; E-H. No recurrence of nasopharyngeal carcinoma lesions seen 24 months postoperatively; I. The tumor tissue surrounding the internal carotid artery (white arrow refers to the internal carotid artery) is removed; G. The tumor tissue on the surface of the optic nerve tube is removed (white arrow refers to the optic chiasm); K. The nasopharynx shows local dryness after radiotherapy and chemotherapy; L. The nasopharynx shows less dryness during 24 months of follow-up.