鼻窦恶性肿瘤71例报告及文献复习与分析。

Bijan Khademi, Azadeh Moradi, Sara Hoseini, Mohammad Mohammadianpanah
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引用次数: 103

摘要

背景:本研究报告71例鼻窦恶性肿瘤的特点、预后因素及治疗结果,并对主要报道系列进行文献复习和分析。方法:选取2000年5月至2008年3月在某大学附属医院接受治疗并随访的71例原发性鼻窦恶性肿瘤患者为研究对象。手术加放化疗34例,单纯手术15例,放化疗联合14例,单纯放疗6例,手术加放疗2例。为了找出近20年来相关研究的主要系列,我们对PubMed进行了文献回顾。我们共发现42个主要系列8,164例鼻窦恶性肿瘤。结果:女性35例,男性36例,年龄5 ~ 80岁,诊断时中位年龄55岁。主要包括51例鼻窦和20例鼻腔。I期1例,II期20例,III期27例,IV期23例。上皮性肿瘤占所有肿瘤的65%。存活患者中位随访39个月后,33例存活且无疾病,8例存活且有疾病,30例因疾病死亡。局部复发是最常见的治疗失败。5年无病生存率、局部控制生存率和总生存率分别为42.1%、59.5%和54.5%。在单因素分析中,颈部淋巴结受累、原发肿瘤大小、组织学类型、对治疗的反应和疾病分期是影响总生存率的独立预后因素。在文献综述中,通过分析42个主要报道系列的数据收集,中位年龄为57岁,男女比为1.8。上皮性肿瘤占所有鼻道恶性肿瘤的69%,III期和IV期占所有分期的74.7%。局部复发是几乎所有系列的主要治疗失败。5年局部控制率和总生存率分别为56%和45.5%。结论:在本综述中,通过分析近期主要报道系列的大量资料,我们发现鼻道恶性肿瘤往往出现在局部晚期,局部失败的频率高,预后中等至较差。需要更有效的局部治疗来改善局部控制和总体生存。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Malignant neoplasms of the sinonasal tract: report of 71 patients and literature review and analysis.

Background: The present study aimed to report the characteristics, prognostic factors, and treatment outcomes of 71 cases of malignant neoplasms of the sinonasal tract and literature review and analysis of major report series.

Methods: Seventy-one consecutive patients diagnosed with primary malignant neoplasm of the sinonasal tract that were treated and followed up at a university hospital between May 2000 and March 2008 were selected for the present study. Thirty-four patients were treated with surgery followed by a combination of chemotherapy and radiotherapy, 15 with surgery alone, 14 with combined radiotherapy and chemotherapy, six with radiotherapy alone, and two with surgery followed by radiotherapy. To find out the major series of related studies over the last 20 years, a literature review of PubMed was performed. In all, we found 42 major series including 8,164 patients with malignant neoplasms of the sinonasal tract.

Results: There were 35 women and 36 men ranging in age from 5 to 80 years, with a median age of 55 years at diagnosis. The primary sites included were paranasal sinuses in 51 and nasal cavity in 20. There were one case of stage I, 20 of stage II, 27 of stage III, and 23 of stage IV. Epithelial tumors constituted 65% of all neoplasms. After a median follow-up of 39 months for surviving patients, 33 patients are alive and without disease, eight are alive with disease, and 30 patients died due to disease. Local recurrence was the most frequent treatment failure. The 5-year disease-free, local control, and overall survival rates were 42.1%, 59.5%, and 54.5%, respectively. On univariate analysis, cervical lymph nodes involvement, primary tumor size, histologic type, response to therapy, and stage of disease were independent prognostic factors for overall survival. In the literature review and by analyzing the data collection from 42 major reported series, the median age was 57 years and male/female ratio was 1.8. Epithelial tumors consisted of 69% of all malignant neoplasms of sinonasal tract and stages III and IV disease constituted 74.7% of all stages. Local recurrence was the dominant treatment failure in nearly all series. Five-year local control and overall survival rates were 56% and 45.5%, respectively.

Conclusions: In this review and by analyzing the large data collection of recent major reported series, we found that malignant neoplasms of the sinonasal tract tend to present at locally advanced stage, with a high frequency of local failure and a moderate to poor outcome. More effective local treatment for improving the local control and overall survival is needed.

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