- 期刊
鼻咽癌治療後復發的臨床症狀
Clinical Manifestations of Recurrent Nasopharyngeal Carcinoma
摘要
背景：鼻咽癌復發時，經常產生放射治療的併發症，使得腫瘤局部復發或頸轉移不易診斷。為了早期發現鼻咽癌復發，必須了解鼻咽癌復發時的症狀以便早期警覺。 方法：回溯研究54例鼻咽癌經放射治療或化學治療復發的病例。 結果：復發鼻咽癌最常見的臨床症狀依序為鼻症狀(45.1%)及頸部腫塊(29.4%)；最常見復發的位置依序為鼻咽或附近區域(63%)頸部(25.9%)，遠處轉移(16.7%)。鼻咽中復發最常見鄉側壁(53.5%)。復發病人有頸部腫塊者，以Robbins等的頸淋巴節來分區，第2區(level II)佔最多(78.5%)。大部份復發病人EB病毒抗體為陽性。 結論：在追蹤鼻咽癌經放射治療或化學治療的病人，應留意鼻症狀及頸部腫塊；檢查時特別注意鼻咽側壁俷頸部第2區，並輔以EB病毒血清測定，以及早警覺鼻咽的復發。(中耳醫誌 1998;33:113-119。)
並列摘要
Background: Delayed diagnosis of recurrent nasopharyngeal carcinoma (NPC) is often due to the presence of aftereffects from previous radiotherapy. In order to make an early diagnosis of recurrence, it is essential to recognize the clinical mani-festatios of recurrent nasopharyngeal carci-noma. Methods: Retrospective analysis of 54 recurrent NPC patients previously treated by irradiation with/without chemotherapy. Resullts: Nasal symptoms (45.1%) and neck masses (29.4%) are the two most common symptoms of recurrent NPC. The relapse distributios for primary, cervical and distant sites are 63%, 25.9%, and 16.7% respectively. The most common site of recurrence in the nasopharynx is the lateral wall, and for the neck it is in level II (78.5%) as defined by Robbins. Conclusions: In order to detect recur-rent NPC as early as possible, nasal symp-toms and cervical masses should be closely watched for, and lateral wall of nasophar-ynx and level II of the neck have to be meticulously inspected and palpated during follow-up irradiated NPC, especially in cases of a positive EB virus titer.