上皮源性鼻腔筛窦癌(附231例临床及疗效分析)  

Carcinoma of naso ethmoid sinus: analysis of 231 cases

作　　者：高黎[1] 徐国镇[1] 胡郁华[1] 

机构地区：[1]中国医学科学院中国协和医科大学肿瘤医院放射治疗科

出　　处：《中华放射肿瘤学杂志》1999年第1期5-8,共4页Chinese Journal of Radiation Oncology

摘　　要：目的通过回顾性分析，寻找鼻腔、筛窦癌的最佳治疗手段和影响预后的因素。方法对１９５９年６月～１９９１年６月中国医学科学院、协和医科大学肿瘤医院放射治疗科初治的经病理证实的上皮源性的鼻腔、筛窦癌共２３１例进行了回顾性分析。治疗方式：单纯放射治疗１７９例；放射治疗＋手术的综合治疗５０例，其中计划性术前放射治疗＋手术４２例，手术（手术切缘不净或安全界不够）＋术后放射治疗８例；单纯手术２例。结果２３１例鼻腔、筛窦癌患者中，原发于鼻腔５５例，筛窦３例，鼻中隔３例，其余由于就诊时局部肿瘤较晚无法确定原发部位。２３１例５年生存率４２．１％；单纯放射治疗５年生存率为３４．１％，放射治疗＋手术为６１．９％（Ｐ＜０．０１）。结论根据病期、病理类型来选择鼻腔、筛窦癌的治疗手段，可获得较好的疗效。早期病例单纯放射治疗或放射治疗＋手术的综合治疗均可获得较高的控制率和５年生存率，晚期应以综合治疗为主。分化差的鼻腔、筛窦癌应首选单纯放射治疗，而鳞癌则以放射治疗＋手术的综合治疗为宜。的分期标准，作者采用庄承海分期方法［４］。分期依据：除单纯手术和手术＋放射治疗的病例为根据手术标本病理检查作为分期依据外，７０年代以前，采用临床检查和鼻腔、副鼻?Objective To evaluate the credibility of combined radiotherapy and surgery for cancer of the nose and ethmoid sinuses and their prognostic factors.Methods 231 patients with such cancers treated from June 1959 to June 1991 received either radiotherapy only ( R group, 179), radiotherapy plus surgery(R+S group, 42), surgery plus radiotherapy (S+R group, 8) or surgery alone(S group, 2). Median dose of 70Gy was given to R group, 50Gy to R+S group. Limited resection was done for surgery.Results The overall 5 year survival rate was 42.1%. The 5 year survival rates of R and R+S groups were 34.1% and 61.9%. The 5 year survival rates of Stage Ⅰto Ⅳ lesions were 79.2%, 61.1%,40.9% and 24.3%, respectively.Conclusions For early lesions(Stage Ⅰand Ⅱ) and poorly differentiated cancer, R alone or S+R give better results. For advanced lesions (Stage Ⅲ and Ⅳ), combined radiotherapy and surgery is preferred. Radiotherapy alone is indicated for poorly differentiated cancers. Combined radiotherapy plus surgery is preferred for squamous cell carcinoma.

关 键 词：综合疗法 鼻窦肿瘤 放射疗法 筛窦癌 疗效 

分 类 号：R739.620.5[医药卫生—肿瘤] R730.58[医药卫生—临床医学]