鼻咽癌__培训课件.pptVIP

Imaging Study MRI of NP ---- better than CT MRI of NP ---- better than CT Metastasis Type: 1.Bone 2.Liver 3.Lung 4.Other: abdominal nodes Lung metastasis Liver metastasis 八 Differential Diagnosis 成人腺样体增生 鼻咽腺样体 成人淋巴组织增生 鼻咽扁桃体增生 Adenoids Differential Diagnosis 鼻咽结核 中线坏死性肉芽肿 Median Necrotic Granuloma tuberculosis 分期-国际抗癌联盟（UICC） 分期目的： 制定合理治疗方案 正确评价治疗效果 判断预后 有利于交流 TNM分期（CTNM/PTNM ） T(tumor) ：原发肿瘤 N(node) ： 区域淋巴结 M(metastasis) ：远处转移 九 NPC ’92 Clinical Classification T staging T1: tumor limited to the nasopharynx. T2: tumor involving nasal cavity, oropharynx, soft palate, and parapharyngeal space. Extension before SO-line T3: tumor extension over SO-line, involving either anterior or posterior cranial nerves, base of skull pterygoprocesse zone, pterygopalatine fossa. T4: tumor involving both anterior and posterior cranial nerves, paranasal sinus, cavernous sinus, orbit, infratemporal fossa, and direct invasion of first and second cervical vertebrae N - M Staging N1: Upper neck nodes 4cm, mobile N2: Lower neck nodes or nodes 4~7cm; N3: Node 7cm or supraclavicular node,or fixed node M0: no metastasis M1: metastasis Treatment Option ★ Radiotherapy: Radical（根治手段） ★ Chemotherapy: Adjuvant ★ Operation: Complementary Treatment protocol -- stratified therapy Radiotherapy ＋ Induction or Concomitant ＋ Adjuvant chemotherapy Radiotherapy ＋ Induction or Adjuvant chemotherapy N2-3 Radiotherapy ＋ Induction or Concomitant chemotherapy Radiotherapy N0-1 T3-4 T1-2 Radiotherapy: Radical 眼 鼻咽 口腔 大脑 脑干 鼻 LN 照射区 铅 挡 块 模拟定位照片和复位照片，示照射范围(Ia) Radiotherapy: Radical 铅挡块 Brachytherapy is most often used to manage cancers that have recurred (come back) after treatment. It may also be used to treat the small original tumor. Intensity Modulated Radiation Therapy (IMRT) A new metho