السيطرة على الانتقالات العقدية المتقدمة: فعالية تجريف العنق والعلاج الشعاعي
Abstract
الموضوع: يبقى تجريف العنق الطريقة المعتمدة لتدبير الانتقالات العقدية الرقبية من الكارسينوما شائكة الخلايا في أورام الرأس والعنق. تسلط هذه الدراسة الضوء على فعالية تجريف العنق الجذري، والجذري المعدل المشرك مع العلاج الشعاعي لتدبير الانتقالات العقدية الرقبية N2، N3 في الكارسينوما الشائكة الخلايا في الرأس والعنق. الطرق: تمت الدراسة بصورة راجعة من تموز 2010 إلى حزيران 2014 على 43 عنق مجرّف، عند 39 مريضاً مصاباً بانتقال عقدي رقبي مرحلة ثانية أو ثالثة، عولجوا بشكل مبدئي بتجريف عنق متبوع بعلاج شعاعي. جميع المرضى لديهم كارسينوما شائكة الخلايا في الرأس والعنق. استمرت مدة المتابعة سنتين بعد الجراحة. الخلاصة: إن إشراك تجريف العنق الجذري أو الجذري المعدل مع العلاج الشعاعي فعال بشكل كبير في السيطرة على الانتقال العقدي في حال السيطرة الموضعية على الورم البدئي، مع المحافظة على العصب الشوكي إذا كانت الحالة الورمية تسمح بذلك. Objective: Neck dissection remains the standard method of treating cervical metastasis from head and neck squamous cell carcinoma. We reviewed our experience with radical and modified RND (MRND) plus radiotherapy as treatment for N2/N3 neck disease in head and neck squamous cell carcinoma. Methods we retrospectively reviewed our clinical records from july 2010 to june 2014 identify 43 neck dissections in 39 patients who were found to have N2 or N3 neck disease treated primarily by neck dissection and postoperative radiotherapy. All patients had head and neck squamous cell carcinoma with a minimum follow up of 24 months. Conclusions the combination of RND or MRND and radiotherapy is effective in controlling neck disease in the absence of persistent or recurrent local disease. MRND supports preservation of the spinal nerve whenever oncologically feasible.Downloads
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