目的 评价吻合血管的股前外侧皮瓣在头颈肿瘤术后复杂缺损修复中的作用。方法 1990年5月-2：001年4月，应用吻合血管的股前外侧皮瓣移植，修复田颊癌、喉癌、面部皮肤癌、上颌窦癌术后大面积软组织复杂缺损2I例。结果 19例成功，1例皮瓣部分坏死，1例失败。随诊6个月到10年．9例无瘤生存，外观及功能满意；2例带瘤生存；5例死十局部复发；4例分别死于颈淋巴结转移、脑转移、第二原发癌及脑血管意外；1例失访。 结论 吻合血管的股前外侧皮瓣可提供充足的组织量、存活率高、供区隐蔽、不牺牲重要血管，适用于修复头颈肿瘤术后复杂缺损。

背景与目的：喉癌手术越来越强调保留尽可能多的正常组织，这往往增加切缘阳性的机率，影响病人预后，正确确定切缘标准和原则，对患者预后有利。本研究旨在探讨部分喉切除术术中留取切缘标本对喉癌病人术后治疗的指导价值以及阳性切缘对预后的影响。方法：研究了115例术中留取切缘标本的喉癌病例。比较切缘阴性组与阳性组的复发率、生存曲线；比较切缘阳性组给予与不给予术后放疗者的生存曲线；比较切缘阴性组给予与不给予术后放疗者的生存曲线。结果：切缘阳性组的复发率较阴性组高（28.0% Vs 7.8% P=0.006)、生存曲线差（P=0.0241）；切缘阳性组术后放疗者与未放疗者的生存曲线有显著性差异（P=0.0046）；切缘阴性组给予与不给予术后放疗组的生存曲线无明显差异（P=0.0829）。结论：在喉癌中，切缘阳性组的预后差于阴性组，手术切除干净最重要；术后放疗能改善切缘阳性者的预后；切缘阴性者不必术后放疗。

Our laboratory has investigated the anticancer effects of combined manumycin (a farnesyltransferase inhibitor) and paclitaxel (a microtubule inhibitor) against anaplastic thyroid carcinoma (ATC). In this study we reported the in vivo efficacy of this combination against ATC cells and the lack of toxicity of this treatment in mice. We observed that manumycin-treated tumors looked paler than both control and paclitaxel-treated tumors. We hypothesized that angiogenesis inhibition mediated part of the in vivo effect of manumycin. This hypothesis was supported by the findings that manumycin significantly inhibited angiogenesis (as directly demonstrated by measurement of hemoglobin content and vascular area) in Matrigel implanted into mice, that manumycin decreased the vascular endothelial growth factor in hypoxic ATC cells, and that both manumycin and paclitaxel inhibited endothelial cell proliferation. Interestingly, inhibition of endothelial tubule formation in Matrigel was enhanced by combining manumycin and paclitaxel. As angiogenesis and tumor growth are continuous processes, we investigated the effect of sustained delivery of manumycin and found that paclitaxel plus slow release manumycin (13.25mg/kgzweek) inhibited ATC xenografts more than paclitaxel plus intermittent manumycin (15mg/kgzweek). In conclusion, manumycin plus paclitaxel is an effective combination against ATC, and inhibition of angiogenesis plays a role in the antineoplastic effect of this combination.

目的：探讨不同修复方法在头颈部恶性肿瘤术后缺损I期修复与重建中的作用，评价其临床效果。方法：1989年1月至1998年12月，我们对258例头颈部恶性肿瘤患者的术后缺损进行了I期修复与重建，患者年龄23～81岁，中位年龄51 3岁，男160例，女98例。缺损部位包括：头皮62例，颈部40例，口颊部39例，鼻部29例，唇颏部27例，颧颞部22例，下颌骨20例，舌及口底部12例，其它7例。修复方法：局部皮瓣修复75例；局部皮瓣加游离植皮53例；邻近组织瓣修复加游离植皮47例；肌皮瓣18例；肌皮瓣加局部皮瓣或游离植皮25例；游离组织瓣移植30例；游离组织瓣加邻近组织瓣修复3例；组织代用品7例。结果：全组258例病人，共采用276个皮瓣及组织代用品修复。手术成功224例，手术基本成功23例，手术失败11例。结论：头颈部肿瘤术后I期修复与重建可最大限度地减少术后功能障碍和畸形，提高患者生存质量。