Myers Larry L, Oxford Lance E
Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-9035, USA.
Surg Oncol Clin N Am. 2004 Jan;13(1):167-86. doi: 10.1016/S1055-3207(03)00115-7.
Paranasal sinus malignancies are challenging to treat. Most patients present with advanced lesions, often with intracranial or intraorbital extension, and have a poor overall prognosis. Given the low incidence and diverse pathologies of paranasal sinus cancers, it is extremely difficult to perform prospective, randomized clinical trials to compare different treatment approaches. Improving the prognosis of these cancers continues to be a difficult task, even in light of advances in surgical techniques,radiation delivery techniques, and new chemotherapeutic agents. Cranio-facial resection techniques developed in the past few decades have cured many patients with skull base invasion, who would have been considered unresectable in the past. Furthermore, improvements in radiation therapy can allow more accurate administration to the desired region, with decreased damage to surrounding structures such as the orbit and brain. Aggressive and oncologically sound surgical resection combined with radiation therapy remains the treatment of choice for most patients.Finally, advances in the diagnosis and staging by use of molecular or DNA markers of tumor behavior may allow for more directed therapy.
鼻窦恶性肿瘤的治疗具有挑战性。大多数患者就诊时已处于病变晚期，常伴有颅内或眶内侵犯，总体预后较差。鉴于鼻窦癌发病率低且病理类型多样，开展前瞻性、随机临床试验以比较不同治疗方法极为困难。即便有手术技术、放疗技术及新型化疗药物的进展，改善这些癌症的预后仍是一项艰巨任务。过去几十年发展起来的颅面切除技术已治愈了许多曾被认为无法切除的颅底侵犯患者。此外，放射治疗的改进能使放疗更精准地作用于目标区域，同时减少对眼眶和大脑等周围结构的损伤。积极且符合肿瘤学原则的手术切除联合放射治疗仍是大多数患者的首选治疗方法。最后，利用肿瘤行为的分子或DNA标志物进行诊断和分期方面的进展可能会实现更具针对性的治疗。
