嗅神经母细胞瘤综合治疗疗效及失败模式分析  

An analysis of multimodal treatment outcomes and patterns of treatment failure in esthesioneuroblastoma

作　　者：尹珍珍[1] 高黎[1] 罗京伟[1] 易俊林[1] 黄晓东[1] 王凯[1] 曲媛[1] 张世平[1] 李素艳[1] 肖建平[1] 徐国镇[1] 

机构地区：[1]北京协和医学院 中国医学科学院肿瘤医院放疗科,100021

出　　处：《中华放射肿瘤学杂志》2015年第5期534-538,共5页Chinese Journal of Radiation Oncology

基　　金：中国医药卫生事业发展基金（2009-05）

摘　　要：目的：分析嗅神经母细胞瘤单中心的治疗疗效及失败模式。方法回顾性分析本院1979—2014年间初诊112例无远处转移嗅神经母细胞瘤病例，改良Kadish分期A期1例、B期23例、C期60例、D期28例。手术＋术后放疗±化疗者51例，放疗±化疗者46例，术前放疗＋手术±化疗者11例，手术±化疗者3例，单纯化疗者1例。 Kaplan.Meier 法计算生存率。结果全组5年样本数44例，5年OS和DFS分别为66％和55％，术前放疗＋手术±化疗者分别为91％和82％，手术＋术后放疗±化疗者分别为80％和66％，放疗±化疗者分别为46％和37％。3例单纯手术均出现复发，1例姑息化疗者生存时间为6个月。全组共47例治疗失败，失败率为42％，以远处转移为首次失败方式者占总失败的53％、局部区域复发占36％、同时存在局部区域复发及远处转移者为11％。结论嗅神经母细胞瘤治疗仍推荐放疗＋手术综合治疗方案。综合治疗模式下嗅神经母细胞瘤局部区域控制率及疗效尚可，主要失败方式为远处转移。Objective To evaluate the multimodal treatment outcomes and patterns of treatment failure in esthesioneuroblastoma at a single institution. Methods One hundred and twelve patients who were newly diagnosed with esthesioneuroblastoma but no distant metastasis in our institution from 1979 to 2014 were retrospectively analyzed. The treatment modes, outcomes, and patterns of treatment failure in these patients were analyzed. According to the modified Kadish staging system, the numbers of patients with stage A, B, C, and D esthesioneuroblastoma were 1, 23, 60, and 28, respectively. Fifty.one patients received surgery and postoperative radiotherapy with or without chemotherapy;forty.six patients received radiotherapy with or without chemotherapy;eleven patients received preoperative radiotherapy and surgery with or without chemotherapy;three patients received surgery with or without chemotherapy; one patient received chemotherapy alone. The survival rates were calculated using the Kaplan.Meier method. Results In all patients, the 5.year sample size was 44, and the 5.year overall survival （ OS ） and disease.free survival （ DFS） rates were 66.4% and 54.7%, respectively. The 5.year OS and DFS rates were 91% and 82% in patients who received preoperative radiotherapy and surgery with or without chemotherapy, 80% and 66% in patients who received surgery and postoperative radiotherapy with or without chemotherapy, and 46% and 37% in patients who received radiotherapy with or without chemotherapy. Three patients treated with surgery alone had relapse of the disease;one patient treated with palliative chemotherapy survived 6 months. Treatment failed in 47 （ 42%） out of 112 patients. In patients with failed treatment, 53% had distant metastasis as the first pattern of treatment failure, 36% had locoregional relapse, and 11% had concurrent distant metastasis and locoregional relapse. Conclusions Surgery combined with radiotherapy is still the recommended multimodal treatment regimen for esthesioneuroblastoma. The multi

关 键 词：嗅神经母细胞瘤/放射疗法 治疗结果 失败模式 

分 类 号：R739.4[医药卫生—肿瘤]