Naficy S, Disher M J, Esclamado R M
Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical Center, Ann Arbor 48109-0312, USA.
Am J Rhinol. 1999 Jul-Aug;13(4):311-4. doi: 10.2500/105065899782102872.
Adenoid cystic carcinoma of the paranasal sinuses is a rare neoplasm whose propensity for perineural spread frequently results in positive surgical margins at the skull base. Radiation therapy (RT) may be used to treat unresectable tumors or as an adjuvant for positive surgical margins after attempted resection. A retrospective review of the experience at the University of Michigan Medical Center was undertaken to study the factors influencing survival and to compare the efficacy of RT alone versus as an adjuvant treatment to surgical resection. All patients selected for review (n = 17) had a histologically confirmed diagnosis of adenoid cystic carcinoma arising from the paranasal sinuses with an average follow-up of 6 years. The choice of treatment modality was based upon the resectability of the tumor by clinical and radiologic parameters. This was therefore not a randomized study and there was a clear bias against the radiation only group, which contained the more advanced and locally aggressive tumors. The 6-year survival for the combined surgery + RT group was 73% compared with 50% for the radiation only group (p = NS). The overall local recurrence rate was 76% and the rate of distant metastases was 18%. Of the 10 patients who underwent surgical resection eight (80%) had positive surgical margins at the skull base.
鼻窦腺样囊性癌是一种罕见的肿瘤，其沿神经周围扩散的倾向常常导致颅底手术切缘阳性。放射治疗（RT）可用于治疗无法切除的肿瘤，或作为尝试切除术后手术切缘阳性的辅助治疗。对密歇根大学医学中心的经验进行了回顾性研究，以探讨影响生存的因素，并比较单纯放疗与手术切除辅助放疗的疗效。所有入选进行回顾的患者（n = 17）均经组织学确诊为鼻窦腺样囊性癌，平均随访6年。治疗方式的选择基于肿瘤通过临床和影像学参数的可切除性。因此，这不是一项随机研究，且明显不利于单纯放疗组，该组包含更多进展期和局部侵袭性肿瘤。联合手术+放疗组的6年生存率为73%，而单纯放疗组为50%（p = 无显著性差异）。总体局部复发率为76%，远处转移率为18%。在接受手术切除的10例患者中，8例（80%）颅底手术切缘阳性。
