【摘要】：目的：比較不同外科手術(shù)方式對(duì)鼻咽癌放療后頸部淋巴結(jié)殘留或復(fù)發(fā)補(bǔ)救治療療效的影響，探討鼻咽癌放療后頸部淋巴結(jié)殘留或復(fù)發(fā)的有效手術(shù)方式 方法：回顧性分析102例行外科補(bǔ)救治療的鼻咽癌放療后頸淋巴結(jié)殘留或復(fù)發(fā)病例，其中全頸清掃術(shù)38例,改良性頸清掃術(shù)12例,擇區(qū)性頸清掃術(shù)和頸淋巴結(jié)切除術(shù)各26例。分析殘留或復(fù)發(fā)淋巴結(jié)的位置特征及各位置間相互關(guān)系，比較4種不同手術(shù)方式對(duì)療效的影響，評(píng)估術(shù)后再次放療的價(jià)值。。 結(jié)果：1、102例入組患者外科手術(shù)后的5年累積生存率為42.22%,頸淋巴結(jié)復(fù)發(fā)率為24.5%。 2、鼻咽癌放療后頸淋巴結(jié)殘留或復(fù)發(fā)頸淋巴結(jié)部位以Ⅱ區(qū)為主（54．5％和57．5％），其次是Ⅲ區(qū)，而Ⅳ、Ⅴ、Ⅰ區(qū)則較少。 3、Ⅲ區(qū)和（或）Ⅳ區(qū)殘留或復(fù)發(fā)的病例多多伴其他區(qū)同時(shí)出現(xiàn)，而累及Ⅱ區(qū)和Ⅴ區(qū)者大都以單獨(dú)出現(xiàn)者為多。 4、全頸清掃術(shù)、改良性頸清掃術(shù)、擇區(qū)性頸清掃術(shù)和頸淋巴結(jié)切除術(shù)組5年累積生存率分別為38.8%、59.2%、37.1%和43.7%,差異無(wú)統(tǒng)計(jì)學(xué)意義(χ2=1.0, P=0.8023),頸淋巴結(jié)復(fù)發(fā)率差異也無(wú)統(tǒng)計(jì)學(xué)意義(χ2=0.460, P=0.482)。 5、頸清掃術(shù)后頸部給予與未給予術(shù)后再次放療者的5年累積生存率分別為39.8%和45.8%,差異無(wú)統(tǒng)計(jì)學(xué)意義(χ2=0.06, P=0.8213)。 結(jié)論：廣泛切除術(shù)適應(yīng)于鼻咽癌放療后殘留和復(fù)發(fā)頸淋巴結(jié)累及一個(gè)區(qū)以上和（或）直徑較大和（或）固定者，其余則采用選擇性頸清掃術(shù)，必要時(shí)術(shù)后可行再次放療。
[Abstract]:Objective: to compare the effects of different surgical methods on residual or recurrent cervical lymph nodes after radiotherapy for nasopharyngeal carcinoma (NPC). Methods: a retrospective analysis of 102 cases of residual or recurrent cervical lymph nodes after radiotherapy was performed in 102 cases of nasopharyngeal carcinoma treated with surgical remedy, of which 38 cases were treated by total neck dissection. There were 12 cases of modified neck dissection, 26 cases of selective neck dissection and 26 cases of neck lymph node resection. To analyze the location characteristics of residual or recurrent lymph nodes and the relationship between each other, to compare the effects of 4 different surgical methods on the curative effect, and to evaluate the value of reradiotherapy after operation. Results: the 5-year survival rate was 42.22% and the recurrence rate of cervical lymph nodes was 24.5% in 1102 patients. 2. Region 鈪，

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