内镜经鼻手术治疗前中颅底神经内分泌癌  

Endoscopic endonasal surgery for anterior and middle skull base neuroendocrine carcinoma

作　　者：危维[1] 张秋航[1] 严波[1] 王振霖[1] 齐岩[1] 吕海丽[1] 

机构地区：[1]首都医科大学宣武医院耳鼻咽喉头颈外科颅底外科中心,北京100045

出　　处：《中华耳鼻咽喉头颈外科杂志》2015年第5期357-361,共5页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基　　金：国家自然科学基金面上项目（81170894）;卫生行业科研专项（201202005）;北京市财政专项一学科建设一重点学科（3500-114235）

摘　　要：目的 探讨前中颅底神经内分泌癌的治疗方式及预后.方法 回顾性分析首都医科大学宣武医院2006年11月至2014年6月收治的14例前中颅底神经内分泌癌患者的临床资料.所有患者均行内镜经鼻手术,4例行单纯手术治疗,2例术前行放疗,1例术前行化疗,1例术后行放疗,6例术后行放化疗.采用Kaplan-Meier法进行生存率分析.结果 12例患者肿瘤达到全切,2例次全切除,均无手术并发症.其中分化好的神经内分泌癌3例,中分化2例,小细胞神经内分泌癌9例.术后随访6 ～97个月,中位随访时间36个月,死亡3例,失访1例,5年生存率64.3％.结论 针对不同病理类型采取单纯内镜经鼻手术或以内镜手术为主的综合治疗可能是前中颅底神经内分泌癌可行的治疗方式。Objective To investigate the optimal treatment strategy with endoscopic endonasal approach （EEA） and the prognostic factors of anterior and middle skull base neuroendocrine carcinoma （NEC）.Method Fourteen patients with anterior and/or middle skull base NEC,admitted to Xuanwu Hospital between November 2006 and June 2014,were reviewed retrospectively.All patients were treated with EEA.Four cases received surgery onle.Two cases received radiotherapy and one case received chemotherapy before surgery.One case received adjuvant radiotherapy and 6 cases received chemoradiation after surgery.Survival analysis was performed by Kaplan-Meier method.Result Complete resection was achieved in 12 cases,while subtotal resection was achieved in 2 cases.There was no surgical complication.Three cases were diagnosed as well-differentiated NEC,2 cases were moderately differentiated NEC and 9 cases were small cell NEC.The patients were followed up for 6 to 97 months.Three patients died and one patient lost to follow-up.The 5-year survival rate in this group was 64.3%.Conclusion Pure EEA or EEA combined with multimodality therapy,which was applied depending on the pathological type,was a feasible treatment strategy for anterior and middle skull base NEC.

关 键 词：颅底肿瘤 癌 神经内分泌 内窥镜检查 鼻外科手术 治疗结果 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]