老年人口腔颌面部肉瘤33例临床分析  

Sarcoma of the elderly in oral and maxillofacial region:Clinical analysis of 33 consecutive patients

作　　者：高宪超[1] 季彤[1] 钟来平[1] 魏魁杰[1] 王丽珍[2] 乔士冲[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院·口腔医学院口腔颌面外科,上海200011 [2]上海交通大学医学院附属第九人民医院·口腔医学院口腔病理科,上海市口腔医学重点实验室,上海200011

出　　处：《中国口腔颌面外科杂志》2010年第3期219-224,共6页China Journal of Oral and Maxillofacial Surgery

基　　金：上海市科学技术委员会资助项目(08DZ2271100);上海市卫生局资助项目(2009076)~~

摘　　要：目的:探讨老年人口腔颌面部肉瘤的临床特点及预后。方法:收集2000—2009年治疗的33例老年人(>60岁)口腔颌面部肉瘤病例进行回顾性分析。利用SPSS12.0软件包进行统计学分析,预后影响因素采用χ2检验。根据随访资料,采用乘积极限法统计生存率。结果:33例患者中,男23例,女10例。平均年龄71岁(61～88岁),平均随访时间21个月(3～83个月)。随访患者29例,失访患者4例,随访率为87.88%。随访患者中,原发病例20例,因肉瘤复发就诊(复发病例)9例。随访病例均经手术治疗,其中单纯手术治疗12例,术后辅助放疗9例,术后辅助放化疗8例。经χ2检验,单纯手术治疗组和术后辅助放化疗组对预后有显著影响(P<0.05)。原发病例中,术后局部复发11例,复发率55%。复发病例中,7例术后出现复发,2例出现远处转移。随访病例中,1年生存率为69%,3年生存率为40.8%,5年生存率为25.4%。单纯手术治疗组和术后联合放化疗组的生存函数采用Logrank检验进行比较,差异具有显著性。结论:手术是治疗老年人口腔颌面部肉瘤的主要手段。根治性手术联合术后放化疗对改善老年肉瘤患者的预后可能有益。PURPOSE： To report outcome on patients over 60 years of age with sarcoma in oral and maxillofacial region,with respect to clinical behaviors,treatment and prognosis.METHODS： Retrospective analysis of patients over 60 years of age with histologically proven oral and maxillofacial sarcomas treated in Dept.of Oral and Maxillofacial Surgery,Ninth people＇ s Hospital,Shanghai Jiao Tong University School of Medicine,from 2000 to 2009 were performed.Differences between groups were assessed using Chi-squared test.Overall survival was calculated using Kaplan-Meier product limit method and the impact of prognostic factors was assessed using the Log rank test in univariate analysis.RESULTS： During this period,33 patients with oral and maxillofacial sarcomas were registered.The average follow-up was 21 months （ 3 to 83 months ）.29 patients were followed up,with 20 referred for treatment of primary disease.The remaining 9 patients were treated for recurrent or incompletely excised disease.Treatment protocols were surgery alone,postoperative radiotherapy and postoperative radiotherapy plus adjuvant chemotherapy in 12,9 and 8 cases,respectively.An univariate analysis indicated that significant poor prognostic factors for overall survival without postoperative radiotherapy plus adjuvant chemotherapy treatment.The 1,3-and 5 -year survival rates for the entire group were 69% ,40.8 % and 25.4%。 CONCLUSION： Radical resection associated with postoperative radiotherapy plus adjuvant chemotherapy of oral and maxillofacial sarcomas may be important prognostic factors affecting survival of the elder patients with oral and maxillofacial sarcoma.

关 键 词：口腔颌面部 肉瘤 治疗 老年人 

分 类 号：R739.8[医药卫生—肿瘤]