Nasopharyngeal carcinoma (NPC) is sensitive to radiotherapy, mainly radiotherapy, but there is nothing we can do about the following situations: 1 remnants after the first radical radiotherapy. (2) recurrence after radiotherapy. (3) relapse or remnant after two-course treatment.
Salvage surgery for nasopharynx (including salvage surgery for primary focus or failure of neck radiotherapy) is an effective treatment.Only 25% of the patients who received two-course radiotherapy after primary recurrence of nasopharyngeal carcinoma were effective, the 5-year survival rate was 12%-23%, and the radiation injury was greater. If the two-course radiotherapy relapses, the three-course radiotherapy is ineffective. 1 the recurrence rate of cervical lymph node metastasis of nasopharyngeal carcinoma after radiotherapy was 91%. 32% of the patients with cervical recurrence after radiotherapy had multiple lymph node metastasis, 70% of the positive lymph nodes were located in the posterior cervical triangle (along the accessory nerve), and 29% to 77.9% of the patients had external lymph node invasion. the 5-year overall survival rate after cervical two-course radiotherapy was only 11%-28%, and could cause serious complications. The 5-year overall survival rate after nasopharyngeal and cervical recurrence was 7%. 2 Clinical practice has proved that salvage surgery for primary or cervical recurrence or residual lesions of nasopharyngeal carcinoma after radiotherapy, the cure rate is significantly higher than that of two-course radiotherapy, and the 5-year survival rate of primary recurrence is 44%-51%. The 5-year survival rate of neck recurrence or residual surgery was 25%-67%.Salvage surgery for nasopharyngeal carcinoma is suitable for: (1) patients with uncontrolled primary focus or recurrence of nasopharyngeal carcinoma after radiotherapy and / or patients with uncontrolled or recurrent cervical metastatic lymph nodes. (2) in patients with local recurrence, there was no bone destruction of skull base and cerebral nerve paralysis. (3) there was no distant metastasis.
Salvage surgery for nasopharyngeal carcinoma is prohibited for: 1 patients with skull base bone destruction or cerebral nerve paralysis. (2) the residual or recurrent lesions of the neck are extensively adhered to the deep tissue of the neck or the skin. 3There were distant metastasis. 4 years old, frail, poor general condition or hepatic and renal insufficiency. (5) there are other contraindications for operation.
