不明原发灶颈部转移癌治疗失败原因和对策

R73; 目的 分析不明原发灶颈部转移癌(unknown primary cervical metastatic carcinoma,UPCMC)的治疗方法和治疗失败原因,探讨其治疗策略.方法回顾性研究1978年1月～1997年12月收治的符合诊断标准的UPCMC111例的临床资料、治疗和转归,比较和分析不同治疗组的颈部控制率、原发灶治疗失败率及远期生存率.结果 全组原发灶出现率10.8%(12/111),颈部控制率为36.9%,总的5年生存率为41.4%;影响预后的因素为颈部控制情况、N分期、原发灶控制情况,颈部控制率的影响因素为N分期和是否全颈放疗.结论 UPCMC的颈部治疗应以放疗为主,...

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Published in中德临床肿瘤学杂志（英文版） Vol. 4; no. 3; pp. 132 - 136
Main Authors 彭汉伟, 郭朱明, 曾宗渊, 陈福进, 李浩, 魏茂文, 伍国号, 张诠, 杨安奎
Format Journal Article
LanguageChinese
Published 广州中山大学肿瘤防治中心头颈科,510060 2005
Subjects
颈部转移癌,原发灶不明
cervical metastasis,unknown primary
radiotherapy
综合治疗
synthetic therapy
外科手术
放射治疗
surgery
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Abstract R73; 目的 分析不明原发灶颈部转移癌(unknown primary cervical metastatic carcinoma,UPCMC)的治疗方法和治疗失败原因,探讨其治疗策略.方法回顾性研究1978年1月～1997年12月收治的符合诊断标准的UPCMC111例的临床资料、治疗和转归,比较和分析不同治疗组的颈部控制率、原发灶治疗失败率及远期生存率.结果 全组原发灶出现率10.8%(12/111),颈部控制率为36.9%,总的5年生存率为41.4%;影响预后的因素为颈部控制情况、N分期、原发灶控制情况,颈部控制率的影响因素为N分期和是否全颈放疗.结论 UPCMC的颈部治疗应以放疗为主,部分放射不敏感病理类型的N1、N2病例可采取放疗和手术的综合治疗;颈部放疗以全颈放疗为佳;对潜在原发灶的治疗推荐采取选择性放疗的策略.
AbstractList R73; 目的 分析不明原发灶颈部转移癌(unknown primary cervical metastatic carcinoma,UPCMC)的治疗方法和治疗失败原因,探讨其治疗策略.方法回顾性研究1978年1月～1997年12月收治的符合诊断标准的UPCMC111例的临床资料、治疗和转归,比较和分析不同治疗组的颈部控制率、原发灶治疗失败率及远期生存率.结果 全组原发灶出现率10.8%(12/111),颈部控制率为36.9%,总的5年生存率为41.4%;影响预后的因素为颈部控制情况、N分期、原发灶控制情况,颈部控制率的影响因素为N分期和是否全颈放疗.结论 UPCMC的颈部治疗应以放疗为主,部分放射不敏感病理类型的N1、N2病例可采取放疗和手术的综合治疗;颈部放疗以全颈放疗为佳;对潜在原发灶的治疗推荐采取选择性放疗的策略.
Abstract_FL To analyze the patterns of relapse and management options in unknown primary cervical metastatic carcinoma (UPCMC) as well as to discuss its treatment strategies. Methods: Clinical data of 111 cases of eligible UPCMC were retrospectively studied. Neck control, primary relapse and longterm survival were compared among different groups. Results: Primary carcinomas ultimately appeared in 12 cases (10.8%, 12/111). Neck control rate was 36.9%. Overall 5-year survival rate was 41.4%. Neck control, N stage and primary control were prognostic factors for UPCMC. Neck control was affected by N stage and whether or not comprehensive radiotherapy was administered. Conclusion: UPCMC should primarily be treated by radiotherapy except for cases with N1 or N2 insensitive to radiation. Bilateral necks radiotherapy is the optimal choice in terms of neck radiotherapy. Selective total pharyngeal irradiation is recommended for potential primary treatment.
Author 彭汉伟
杨安奎
魏茂文
伍国号
郭朱明
陈福进
李浩
张诠
曾宗渊
AuthorAffiliation 广州中山大学肿瘤防治中心头颈科,510060
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Author_FL ZHANG Quan
YANG Ankui
CHEN Fujin
PENG Hanwei
LI Hao
GUO Zhuming
WEI Maowen
WU Guohao
Zeng Zongyuan
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Keywords 颈部转移癌,原发灶不明
cervical metastasis,unknown primary
radiotherapy
综合治疗
synthetic therapy
外科手术
放射治疗
surgery
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Title 不明原发灶颈部转移癌治疗失败原因和对策
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