原发灶不明的颈部淋巴结转移癌的临床分析

发布时间：2018-04-26 01:16

本文选题：颈部转移癌 + 放射疗法　；参考：《国际医药卫生导报》2004年12期

【摘要】：目的　探讨原发灶不明的颈部淋巴转移癌的治疗和预后。方法　对92例原发灶不明的颈部转移癌进行回顾性分析。结果　全组3年生存率为46.8%,5年生存率为30.4%,影响颈部淋巴转移癌疗效的原因主要是临床分期,颈部转移灶的部位,病理类型,放疗技术,治疗方法。结论原发灶不明的颈部淋巴结转移癌临床分期越早,预后越好,上中颈部转移癌预后明显比锁骨上好,鳞癌和未分化癌比腺癌好。对于上中颈部中低化鳞癌和未分化癌应采用全咽和全颈照射,除锁骨上淋巴结转移癌以外,原发灶不明的颈部淋巴结转移癌照射至少应包括全颈部,腺癌及高分化鳞癌以手术为主,必要时局部加以放疗,中晚期颈部淋巴转移癌应以手术加放疗为主的综合治疗,适当加以化疗。
[Abstract]:Objective to investigate the treatment and prognosis of cervical lymphatic metastasis with unknown primary focus. Methods 92 cases of cervical metastatic carcinoma with unknown primary lesion were retrospectively analyzed. Results the 3-year survival rate was 46.8%, and the 5-year survival rate was 30.4%. The main factors affecting the curative effect of cervical lymphatic metastasis were clinical stage, location of cervical metastasis, pathological type, radiotherapy technique and treatment methods. Conclusion the earlier the clinical stage of cervical lymph node metastasis with unknown primary lesion, the better the prognosis. The prognosis of upper and middle cervical metastatic carcinoma is better than that of supraclavicular carcinoma, and that of squamous carcinoma and undifferentiated carcinoma is better than that of adenocarcinoma. For middle and low squamous cell carcinoma and undifferentiated carcinoma of the upper and middle neck, the whole pharynx and neck should be irradiated. Except for the metastatic carcinoma of the supraclavian lymph node, the exposure of the cervical lymph node metastases with unknown primary focus should include at least the whole neck. Adenocarcinomas and well-differentiated squamous cell carcinomas were mainly treated with surgery and local radiotherapy if necessary. The advanced cervical lymphatic metastases should be treated by surgery plus radiotherapy and chemotherapy should be appropriate.
【作者单位】：东莞市人民医院肿瘤科二区东莞市人民医院肿瘤科二区
【分类号】：R739.91

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