鼻咽癌放疗后鼻咽颅底坏死及肿瘤复发鉴别的研究
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1.广西科技大学第一附属医院;2.广西医科大学第一附属医院

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Differential Study between Skull Base Bone Destruction and Tumor Recurrence after Radiotherapy for Nasopharyngeal Carcinoma
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    摘要:

    目的本研究通过对鼻咽癌放疗后鼻咽颅底坏死及肿瘤复发患者的基本信息、症状、内镜及影像学等进行对比,探讨两者差异性,为患者的诊断提供依据,利于评估和制定精准的治疗方案。方法:以2012年1月至2022年4月间38例鼻咽癌放疗后鼻咽颅底破坏患者为研究对象,根据病理结果分为坏死组和复发组,对比两组性别构成、发病年龄、二次放疗、发病时间、鼻内镜检查表现、CT及MRI影像表现的差异。结果:两组在性别构成、发病时间、二次放疗、鼻腔恶臭、内镜下鼻咽坏死情况及新生物情况、CT骨质破坏表现、鼻咽软组织强化后表现、MRI中软组织及骨髓T2及强化表现上存在显著差异(P<0.05)。结论:通过对鼻咽癌放疗后鼻咽颅底破坏患者的性别、发病时间、临床症状、鼻内镜表现、CT、MRI表现进行综合分析,能够对鼻咽癌放疗后鼻咽颅底坏死与肿瘤复发进行初步鉴别,有助于临床上制定精准的治疗方案。

    Abstract:

    Objective:In this study, the basic information, symptoms, endoscopy and imaging of patients with nasopharyngeal skull base necrosis and tumor recurrence after radiotherapy of nasopharyngeal carcinoma were compared to explore the differences between the two, so as to provide basis for the diagnosis of patients and facilitate the evaluation and formulation of accurate treatment plans.Methods: 38 cases of nasopharyngeal carcinoma patients with nasopharyngeal skull base destruction after radiotherapy from January 2012 to April 2022 were divided into necrosis group and recurrence group according to pathological results. The gender composition, age of onset, secondary radiotherapy, time of onset, endoscopic nasopharyngeal necrosis and new biological conditions, CT and MRI findings of the two groups were compared.Results: There were significant differences between the two groups in gender composition, onset time, secondary radiotherapy, nasal odor, endoscopic nasopharyngeal lesions, CT manifestations of bone destruction, nasopharyngeal soft tissue enhancement, and MRI manifestations of soft tissue and bone marrow T2 and enhancement (P < 0.05).Conclusion: Through comprehensive analysis of the gender, onset time, clinical symptoms, nasal endoscopic findings, CT and MRI findings of the patients with nasopharyngeal skull base destruction after nasopharyngeal carcinoma radiotherapy, we can preliminarily distinguish nasopharyngeal skull base necrosis and tumor recurrence after nasopharyngeal carcinoma radiotherapy, which is helpful for clinical development of accurate treatment plan.

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  • 收稿日期:2024-03-12
  • 最后修改日期:2024-05-26
  • 录用日期:2024-05-27
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