31例头颈部骨外浆细胞瘤患者临床特点及预后分析  

Clinical features and prognosis analysis of 31 cases of extramedullary plasmacytoma of the head and neck

作　　者：王天 田姝 丁浩 Wang Tian;Tian Shu;Ding Hao(Department of Radiation Oncology,Eye Ear Nose and Throat Hospital of Fudan University,Shanghai 200031,China)

机构地区：[1]复旦大学附属眼耳鼻喉科医院放疗科,上海200031

出　　处：《中华放射肿瘤学杂志》2023年第1期1-7,共7页Chinese Journal of Radiation Oncology

摘　　要：目的探讨头颈部骨外浆细胞瘤(EMP)的临床特点、治疗情况及预后相关因素。方法回顾性分析复旦大学附属眼耳鼻喉科医院2005年1月至2020年1月收治的31例头颈部EMP患者的临床资料。按病灶累及部位,分为未累及韦氏环组和累及韦氏环组。采用单因素卡方检验分析组间差异,采用Kaplan-Meier法分析总生存(OS)期。组间OS率和无局部复发生存(LRFS)率比较用log-rank检验。结果31例患者全部接受了放射治疗,中位随访时间98(7~192)个月。其中16例患者同时接受了手术,10例患者同时接受了化疗,2例患者同时接受了手术和化疗。15例患者累及韦氏环,16例患者未累及韦氏环。10年OS率84.8%,2例发生了局部复发,2例发展为多发性骨髓瘤。年龄≤55岁和>55岁者10年OS率为100%∶67.0%(P=0.039);累及韦氏环者和未累及者10年OS率为93.3%∶75.2%(P=0.031),二者10年LRFS率为100%∶66.7%(P=0.022)。放疗前肿瘤最长径≤5 cm者10年总生存率达95.0%,>5 cm者为35.7%(P=0.020)。结论头颈部EMP患者放疗前肿瘤最长径≤5 cm者有更好的10年OS率,累及韦氏环者有更好的10年OS率和LRFS率。Objective To investigate the clinical features,treatment options and prognostic factors of extramedullary plasmacytoma of the head and neck.Methods Clinical data of 31 cases of extramedullary plasmacytoma of the head and neck treated in Eye Ear Nose and Throat Hospital of Fudan University from January 2005 to January 2020 were retrospectively analyzed.According to the involvement sites,the lesions were divided into the Waldeyer's ring involvement and non-involvement groups.The differences between two groups were compared by one-way ANOVA.The overall survival(OS)was analyzed by Kaplan-Meier method.The OS rate and local recurrence free survival(LRFS)rate between two groups were compared by log-rank test.Results All 31 patients received radiotherapy.The median follow-up time was 98 months(7-192 months).Among them,16 patients received radiotherapy and surgery,10 patients received radiochemotherapy,and 2 patients received surgery and radiochemotherapy.Waldeyer's ring involvement was found in 15 patients,and Waldeyer's ring was not involved in 16 patients.The 10-year OS rate was 84.8%.Two cases showed local recurrence and 2 cases progressed to multiple myeloma.The 10-year OS rate in patients≤55 years old was 100%vs.67%in those>55 years old(P=0.039).The 10-year OS rates in patients with and without Waldeyer's ring involvement were 93.3%vs.75.2%(P=0.031).The 10-year LRFS rate in patients with Waldeyer's ring involvement was 100%vs.66.7%in those without Waldeyer's ring involvement(P=0.022).The 10-year OS rate was 95%and 35.7%for patients with longest diameter of tumor≤5 cm and>5 cm before radiotherapy,respectively(P=0.02).Conclusions Extramedullary plasmacytoma of the head and neck patients with longest diameter of tumor≤5 cm obtain higher 10-year OS rate.Those with Waldeyer's ring involvement have better 10-year OS and LRFS rates.

关 键 词：骨外浆细胞瘤 头颈部 临床特点 放疗剂量 韦氏环累及 预后 

分 类 号：R739.91[医药卫生—肿瘤]