【摘要】 目的:分析鼻咽癌在放射治疗后出现的头颈部放射性诱发肉瘤(radiation-induced sarcoma, RIS)的临床发病特点、治疗方式及预后，探讨其治疗策略。方法:回顾2013年1月-2022年10月在广西壮族自治区人民医院治疗的鼻咽癌RIS患者。描述其发生时间、发生部位、病理亚型、影像学特征及治疗结果，随访统计总生存期水平。结果:本研究纳入10例患者，鼻咽癌和RIS之间的间隔时间为2～27年，RIS好发于鼻咽部，病理学类型以骨肉瘤为主。总体中位生存期18个月，联合化疗组中位生存期40个月，单纯手术组的中位生存期12个月。1年及2年的累积生存率分别为48%和36%。预后分析显示性别、发病年龄、放疗后肉瘤发生时间、治疗情况与临床预后无明确相关性，骨肉瘤较其他病理类型预后更差。结论:RIS是鼻咽癌患者最严重的远期不良反应。RIS预后差，手术完全切除肿瘤可提高患者的生存率，在手术无法完全切除肿瘤的情况下，放疗或者化疗可能有助于改善预后。更多还原

【Abstract】 Objective: To analyze the clinical features, treatment methods and prognosis of radiation-induced sarcoma(RIS) of the head and neck after radiotherapy for nasopharyngeal carcinoma(NPC), and explore its treatment strategies. Methods: A retrospective analysis was conducted on RIS patients after radiotherapy for NPC in the People’s Hospital of Guangxi Zhuang Autonomous Region from January 2013 to October 2022. The time of onset, lesion location, pathological subtypes, imaging features and treatment outcomes were described, and the median survival time was statistically analyzed through follow-up. Results: This study included 10 patients with an interval of 2-27 years between NPC and RIS. The nasopharynx was the more common site of RIS, and osteosarcoma was the main pathological type. The median overall survival was 18 months. The median survival was 40 months in the surgery combined with the chemotherapy group, and 12 months in the surgery alone group. The 1-and 2-year cumulative survival rates were 48% and 36%, respectively. Prognostic analysis showed that gender, age of onset, time of sarcoma onset after radiotherapy and treatment methods might not be influencing factors for prognosis, and osteosarcomas presented a poorer prognosis than other pathological types. Conclusion: RIS is one of the most severe long-term adverse effects in patients with NPC. The prognosis of RIS is poor, and complete surgical resection of the tumor can improve patient survival rates. In cases where complete surgical resection is challenging, radiotherapy or chemotherapy may offer some improvement in tumor control.更多还原