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摘要: 相比于再程放疗或者开放式手术，内镜手术治疗复发性鼻咽癌有着更优的疗效，不仅提高总体生存率，还减少了严重并发症，提高生活质量，节约医疗成本。随着现代化手术设备器械的进步、颅底领域解剖研究的深入、外科医生素质的提高以及多学科团队协作的发展，内镜手术的安全性、肿瘤完整切除率也将随之提高，手术适应证在进一步扩大，更多的复发性鼻咽癌患者获益于内镜微创手术。本文就复发性鼻咽癌内镜手术治疗的疗效进行综述，进而为复发性鼻咽癌的临床治疗策略选择提供思路。Abstract: Compared with re-radiotherapy or open surgery, endoscopic surgery for recurrent nasopharyngeal carcinoma has a better effect, which not only improves the overall survival rate, but also reduces serious complications, improves the quality of life and saves medical costs. With the advancement of modern surgical equipment and instruments, the deepening of anatomical research in the field of skull base, the improvement of surgical techniques and the development of multidisciplinary teamwork, the safety of endoscopic surgery and the rate of complete tumor resection will also increase. The indications for surgery are further expanded, and more patients with recurrent nasopharyngeal carcinoma benefit from endoscopic minimally invasive surgery. This article reviews the efficacy of endoscopic surgery for recurrent nasopharyngeal carcinoma, and then provides insights for the selection of clinical treatment strategies for recurrent nasopharyngeal carcinoma.
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Key words:
- nasopharyngeal carcinoma /
- recurrence /
- endoscopic surgery
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表 1 内镜下复发性鼻咽癌手术切除的疗效指标
年份 作者 例数 r分期/% 阳性切缘/例(%) 证据级别[26] 是否对比放疗 OS /% DSS /% DFS /% LRFS /% DMFS /% PFS /% 2022 Wang等[19] 37 T2：56.8，T3：43.2 1(2.7) 3 否 88.7a) - - 72.0a) 97.3a) 72.0a) 2021 Liu等[7] 100 T1：35.0，T2：35.0，T3：30.0 6(6.0) 1 是 85.8b) - 76.5b) 89.8b) 92.5a) - 2021 Thamboo等[27] 13 T1：61.5，T2：23.0，T3：15.3 3(23.0) 4 否 84.6c) - 53.9c) - - - 2021 Li等[24] 120 T3：62.5，T4：37.5 35(29.2) 3 否 55.2b) - - - - 29.4b) 2021 Liu等[18] 101 T1：30.7，T2：9.9，T3：30.7，T4：28.7 16(15.8) 3 否 76.2a) - - 53.6a) - - 2017 Vlantis等[28] 18 T1：38.9，T2a：11.1，T2b：33.3，T3：5.6 2(11.1) 4 否 100.0a) - 90.0a) - - - 2017 Wong等[29] 15 T3：13.3，T4：86.7 6(40.0) 3 否 66.7a) 73.3a) 40.0a) - - - 2017 Liu等[20] 91 T1：33.0，T2：14.3，T3：31.9，T4：20.9 17(18.6) 3 否 64.8a) 38.3c) - 57.5a) 30.2c) - - - 2015 Zou等[30] 92 T1：50.0，T2：35.9，T3：14.1 - 3 是 78.1c) - - - 88.6c) - 2015 You等[14] 72 T1：44.4，T2：37.5，T3：18.1 - 3 是 77.1c) - - - - - 2015 Sun等[31] 71 T1：38.0，T2：14.0，T3：26.8，T4：16.3 17(23.9) 3 否 74.0a) 39.0c) - 60.5a) 31.9c) - - - 2015 Chen等[32] 96 T1：22.9，T2：16.7，T3：43.8，T4：16.7 52(54.2) 3 否 68.0a) 63.0b) - - - - - 2012 Ho等[33] 13 T1：46.2，T2a：23.1，T2b：15.4，T3：15.4 4(30.8) 4 否 100.0a) - 69.2a) - - - 2009 Chen等[22] 37 T1：45.9，T2a：10.8，T2b：37.8，T3：5.4 1(2.7) 4 否 84.2a) - - 86.3a) - 82.6a) 2009 Ko等[34] 28 T1：42.9，T2：57.1 3(10.7) 4 否 59.4a) - 57.6a) - - - 注：a)2年；b)3年；c)5年；OS：总体生存率；DSS：疾病特异性生存率；DFS：无病生存率；LRFS：无局部复发生存率；DMFS：无远处转移生存率；PFS：无进展生存率。 
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