嗅神经母细胞瘤49例临床分析  

Clinical analysis of 49 cases of esthesioneuroblastoma

作　　者：毛明峰[1] 王荣光[1] 王洪田[1] 张欣欣[1] 陈雷[1] 

机构地区：[1]解放军总医院耳鼻咽喉头颈外科,北京100853

出　　处：《中华耳鼻咽喉头颈外科杂志》2014年第3期210-213,共4页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

摘　　要：目的 探讨嗅神经母细胞瘤的治疗方法及影响预后的因素.方法 回顾性分析解放军总医院耳鼻咽喉头颈外科2004年10月至2013年6月收治的49例嗅神经母细胞瘤患者的临床资料,采用Kaplan-Meier法分析嗅神经母细胞瘤的治疗方法及影响预后的因素,并比较不同治疗方法的疗效.结果 本组患者总的5年生存率为63.8％.Kadish临床分期A期、B期、C期患者5年生存率分别为90.0％、77.1％、32.6％,不同临床分期患者的生存率比较差异有统计学意义（x2=7.379,P=0.03）.手术＋放疗组、放疗＋化疗组、手术＋放疗＋化疗组患者的5年生存率分别为68.6％、0、92.3％,接受不同治疗方案患者的生存率比较差异有统计学意义（x2=8.140,P=0.02）.B期和C期手术患者中,内镜经鼻入路或联合经颅入路患者及鼻侧切开入路或联合经颅入路患者的5年生存率分别为63.7％、50.0％,接受不同术式治疗患者的生存率比较差异元统计学意义（x2=3.818,P=0.05）.结论 嗅神经母细胞瘤在头颈恶性肿瘤中是预后比较好的.其疗效与临床分期及治疗方式有关.以鼻内镜手术为主的综合治疗方案是首选的治疗模式.Objective To investigate the optimal treatment and prognostic factors of esthesioneuroblastoma（ENB）.Method Forty-nine cases of ENB,received therapies in Chinese people liberation army general hospital from October 2004 to June 2013,were reviewed retrospectively.The therapeutical strategies and prognostic factors were analyzed using the Kaplan-Meier method.Efficacy of different therapeutical strategies was compared.Result The 5-year overall survival（OS） in the group was 63.8%.The 5-year OS of Kadish stage A,B,C were 90.0%,77.1%,32.6%,respectively,with significant difference （x2 =7.379,P =0.03）.The 5-year OS of the patients treated by surgery and radiotherapy,chemoradiotherapy,surgery with chemoradiotherapy were 68.6%,0,92.3%,respectively,with significant difference （x2 =8.140,P =0.02）.The 5-year OS of the patients with transnasal endoscopic resection （or combined with transcranial resection） and lateral rhinotomy （or combined with transcranial resection） were 63.7%,50.0%,respectively,which had no significant difference （x2 =3.818,P =0.05）.Conclusions ENB has a relatively good prognosis in head and neck malignancies,the prognosis is associated with clinical stages and treatment approaches.Transnasal endoscopic surgery based multimodality is the preferable choice.

关 键 词：成感觉神经细胞瘤 嗅觉 鼻肿瘤 鼻腔 综合疗法 预后 

分 类 号：R739.41[医药卫生—肿瘤]