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目的分析不明原发灶颈部转移癌(unknown primary cervical metastatic carcinoma,UPCMC)的治疗方法和治疗失败原因,探讨其治疗策略。方法回顾性研究1978年1月-1997年12月收治的符合诊断标准的UPCMC 111例的临床资料、治疗和转归,比较和分析不同治疗组的颈部控制率、原发灶治疗失败率及远期生存率。结果全组原发灶出现率10.8%(12/111),颈部控制率为36.9%,总的5年生存率为41.4%;影响预后的因素为颈部控制情况、N 分期、原发灶控制情况,颈部控制率的影响因素为N分期和是否全颈放疗。结论UPCMC的颈部治疗应以放疗为主,部分放射不敏感病理类型的N1、N2病例可采取放疗和手术的综合治疗;颈部放疗以全颈放疗为佳;对潜在原发灶的治疗推荐采取选择性放疗的策略。
Objective To analyze the treatment of unknown primary cervical metastatic carcinoma (UPCMC) and the causes of treatment failure, and to explore the therapeutic strategies. Methods We retrospectively studied the clinical data, treatment and outcomes of 111 UPCMC patients who met the diagnostic criteria from January 1978 to December 1997. We compared and analyzed the control rate of the neck and the failure rate of the primary tumor treatment in different treatment groups. Long-term survival rate. Results The incidence of primary lesions was 10.8% (12/111) in the whole group, the control rate in the neck was 36.9%, and the total 5-year survival rate was 41.4%. The factors affecting the prognosis were neck control, N-stage, and primary lesions. Controlling the factors affecting the neck control rate was N stage and whether or not full neck radiotherapy was used. Conclusion UPPMC should be treated with radiotherapy mainly in the neck. Partially insensitive N1 and N2 cases with radiation-insensitive pathology can be combined with radiotherapy and surgery; neck radiotherapy is better with full-neck radiotherapy; treatment of potential primary lesions is recommended Take a selective radiation therapy strategy.