鼻咽癌放疗与颌骨恶性纤维组织细胞瘤  

Secondary malignant fibrous histiocytoma of maxillofacial bone following radiotherapy for nasopharyngeal carcinoma

作　　者：农东晓[1] 农晓琳[2] 徐志文[1] 陆海杰[3] 

机构地区：[1]广西医科大学一附院耳鼻咽喉头颈外科,南宁530021 [2]广西医科大学口腔医院口腔颌面外科 [3]广西医科大学肿瘤医院放疗科

出　　处：《中国医学文摘（肿瘤学）》2007年第3期269-270,272,共3页Journal of Chinese Medical Abstracts·Oncology

摘　　要：目的放射、创伤、骨坏死、化疗等可为骨组织恶性纤维组织细胞瘤（MFH）的诱因。探讨鼻咽癌（NPC）放疗后患者中出现的MFH。方法收集1998年4月至2005年10月确诊为上颌骨MFH患者的资料。所有患者确诊MFH前数年均曾诊断NPC，并行^60Co放疗。结果本组7例（NPC）分别在鼻咽癌行^60Co外照射放疗结束后4～9年确诊为上颌骨MFH，临床及病理表现与骨原发性MFH相同。结论NPC放疗时上颌骨亦接受了约50～80Gy的照射，放射为本组病例的可疑诱因。如采用直线加速器或钴^60Co外照射结合后装治疗NPC，可适当减少外照射剂量，从而减少颌骨接受的照射量，减少颌骨MFH等诱发癌、瘤的危险性。治疗放疗诱发的MFH应根据临床情况选择手术及化疗，建议慎用或不用放射治疗。Objective Irradiation, trauma, infract, chemotherapy may be the predisposing causes of osseous malignant fibrous histiocytoma （ MFH ）. The study is aimed to investigate MFH in patients with nasopharyngeal carcinoma （ NPC ） posterior to radiotherapy. Methods Maxillary MFH cases, who experienced ^60Co radiotherapy for NPC, were reviewed. Results The interval between ^60Co treatment of NPC and diagnoses of MFH in our cases were 4 - 9 years. The clinical and pathological findings conformed to that of primary osseous MFH. Conclusion The maxilla received an estimated radiation dose ranged from 5 0 - 8 0 Gy. Radiation may be the probable predisposing cause of this group. Linear accelerator or ^60Co combine with afterloading brachytherapy may reduce external radiation dose in treating NPC, therefore decrease the exposure dose to the maxilla so as to lower the risk of radiation-induced sarcoma or carcinoma. Surgery and/or chemotherapy were proposed to give basing on clinical condition of radiation-induced MFH. Radiotherapy is not recommended or cautiously chosen.

关 键 词：鼻咽癌 放疗 骨组织恶性纤维组织细胞瘤 

分 类 号：R738.1[医药卫生—肿瘤]