Guillotte-van Gorkum M L, Nasser T, Mérol J C, Legros M, Rousseaux P, Chays A
Service d'ORL du CHU de Reims, Hôpital Robert Debré, Avenue du Général Koenig, 51092 Reims Cedex.
Ann Otolaryngol Chir Cervicofac. 2003 Nov;120(5):296-301.
Ethmoid adenocarcinoma are and represent rare, 2.5 to 3% of head and neck cancers. The 5-year survival is around 50% for all stages. We present a series of 17 patients treated in our institution.
Expose the treatment of these patients and evaluate the results.
A retrospective study of 17 consecutive patients, treated between 1992 and 1999 for an ethmoid adenocarcinoma (15 T4 and 2 T2) and evaluated in 2002, with a mean follow-up of 5.8 years.
In May 2002, 4 (23.53%) patients were alive and disease-free, 3 (17.65%) were alive with recurrence and 10 (58.82%) was died. The 5-year survival with Kaplan Meyer method is 41%.
This series demonstrates the contribution of a combined approach for T3 and T4 tumors. The bifrontal approach induced an important morbidity in our series and should be replaced by the nasofrontal approach. Most teams agree that postoperative radiotherapy is necessary but the appropriateness of chemotherapy is still discussed. Some authors are of the opinion that it has no action on adenocarcinoma and others that it improves survival. It seems to have been efficient in our T4 patients.
筛窦腺癌罕见,占头颈癌的2.5%至3%。各阶段的5年生存率约为50%。我们报告了在我们机构接受治疗的17例患者。
阐述这些患者的治疗方法并评估结果。
对1992年至1999年间连续治疗的17例筛窦腺癌患者(15例T4期和2例T2期)进行回顾性研究,并于2002年进行评估,平均随访5.8年。
2002年5月,4例(23.53%)患者存活且无疾病,3例(17.65%)存活但有复发,10例(58.82%)死亡。采用Kaplan - Meyer法计算的5年生存率为41%。
该系列研究证明了联合治疗方法对T3和T4期肿瘤的作用。在我们的系列研究中,双额入路导致了严重的并发症,应被鼻额入路取代。大多数团队认为术后放疗是必要的,但化疗的合理性仍存在争议。一些作者认为化疗对腺癌无效,而另一些作者则认为化疗可提高生存率。在我们的T4期患者中,化疗似乎是有效的。