口腔颌面肿瘤总论（二）ppt课件.pptVIP

口腔颌面部肿瘤总论(二);口腔颌面肿瘤的治疗 治疗原则 治疗方法 手术、放射治疗 、化疗、生物治疗、其它 口腔颌面肿瘤的预防 ;口腔颌面部肿瘤的治疗;良性肿瘤：手术治疗;;恶性肿瘤：综合序列治疗 combined and sequential therapy 化疗＋手术＋放疗＋其它 　　根据组织来源、细胞分化程度、肿瘤生长部位、临床分期(TNM)及全身情况选择;组织来源 来源不同，治疗方法不同 上皮来源　　　间叶来源 淋巴造血系统 骨肉瘤;细胞分化分化好—手术分化差—放、化疗 生长部位颅底、深部、重要结构—功能障碍面部、皮肤、颌骨肿瘤—手术;;临床分期 早期 晚期—综合治疗 TNM分期(UICC) 全身情况;;口腔颌面部肿瘤的治疗方法;手术治疗原则;防止医源播散 无瘤原则 切缘在正常组织内 整块切除（en bloc） 避免挤压 肿瘤表面纱布覆盖 使用电刀 冲洗更换器械 根治与功能并重;;; Tongue Reconstruction; Mandible Reconstruction;Radiation Therapy ;Principle Radiation sensitive Types of radiation therapy External beam(外照射) vs. Brachytherapy(腔内照射) Common complications;General Principle;Used to: Combined or as single modality Treat localized tumors Treat leukemia and lymphoma Rapidly dividing cell populations are the most sensitive to radiation tumors, epithelial cells, hemopoietic cells(造血细胞) ;Radiobiology;;To patient;Treatment plan system;Complications;Acute Toxicity;Late Toxicity;Chemotherapy ;Used to: Cure cancer Control cancer Relieve symptoms cancer can cause Usually used in addition with the other treatments;Classification of chemotherapy drugs Chemical structure cell cycle the drug interrupts Protocol of chemotherapy mono drug and combination drug Side effect of chemotherapy;Cell and Tumor Kinetics G1 synthesis RNA S DNA synthesis G2 synthesis of mitotic spindle G0 rest M mitosis;;Chemotherapeutic Agents;Alkylating Agents;Antimetabolites;Antitumor antibiotics;Hormones;Plant Alkaloids ;Cell Cycle;Chemotherapy Protocol;Combination Chemotherapy more effective than single agent additive antitumor effects without additive host toxicity delayed resistance to drugs Use Rapidly dividing tumours most susceptible Balance between efficacy and toxicity;Side effect of chemotherapy;Erythema（红斑）;Biotherapies or Immunotherapy (免疫治疗) Cryotherapy (低温治疗) Laser Surgery (激光外科) Thermotherapy (加热治疗) Chinese Medicine (中医药治疗) Gene Therapy(基因治疗);Immunotherapy (active) Non-specific bacillus Calmette-Guerin(mycobacteria