Liu Wen-Sheng, Tang Ping-Zhang, Xu Guo-Zhen
Department of Head and Neck Surgery, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021, China.
Zhonghua Er Bi Yan Hou Ke Za Zhi. 2004 Jun;39(6):328-32.
To study the diagnosis, treatment policy and prognosis in patients with esthesioneuroblastoma.
A retrospective review was conducted in 34 patients treated at Cancer Hospital of CAMS from 1958 to 1998. According to the Kadish system, the patients were staged as follows: stage A, 1 case; stage B, 9 cases; and stage C, 24 cases. Three patients were treated with surgery alone, 9 irradiation alone, and 15 combination with surgery and radiation, 4 combination with radiation and chemotherapy and 3 surgery, radiation and chemotherapy.
The overall 5-year survival rate was 47.1% (16/34). The survival rates for stag A, B, and C were 100% (1/1), 88.9% (8/9), and 29.2% (7/24) respectively. The survival rates for surgery alone, radiation alone and combined therapy were 33.3% (1/3), 33.3% (3/9), and 54.5% (7/24), respectively. The local control rate and distant metastasis rate were 61.8% (21/34) and 32.4% (11/34), respectively. There were 10 patients died of distant metastasis and 5 patients died of local recurrence. The survival rate in patients with early stage (A + B) esthesioneuroblastoma was significantly better than that in patients with advanced stage (C) (chi2 = 8. 174, P = 0.004). The young patients (< or = 30 years) had a remarkable higher distant metastasis rate (chi2 = 3.865, P = 0.049) and poor prognosis (chi2 = 4.194, P = 0.041) than elder patients.
Early detection and combined therapy were important to improve survival rate. The combined therapy with preoperative radiation therapy and surgery could help to achieve excellent local control. Distant metastasis was an important factor which affected the prognosis of the patients.
研究嗅神经母细胞瘤患者的诊断、治疗策略及预后。
对1958年至1998年在中国医学科学院肿瘤医院接受治疗的34例患者进行回顾性研究。根据卡迪什系统，患者分期如下：A期1例；B期9例；C期24例。3例患者仅接受手术治疗，9例仅接受放疗，15例接受手术与放疗联合治疗，4例接受放疗与化疗联合治疗，3例接受手术、放疗及化疗联合治疗。
总体5年生存率为47.1%（16/34）。A期、B期和C期的生存率分别为100%（1/1）、88.9%（8/9）和29.2%（7/24）。单纯手术、单纯放疗及联合治疗的生存率分别为33.3%（1/3）、33.3%（3/9）和54.5%（7/24）。局部控制率和远处转移率分别为61.8%（21/34）和32.4%（11/34）。10例患者死于远处转移，5例患者死于局部复发。早期（A+B）嗅神经母细胞瘤患者的生存率显著优于晚期（C）患者（χ2 = 8.174，P = 0.004）。年轻患者（≤30岁）的远处转移率显著高于老年患者（χ2 = 3.865，P = 0.049），预后较差（χ2 = 4.194，P = 0.041）。
早期发现和联合治疗对提高生存率很重要。术前放疗与手术联合治疗有助于实现良好的局部控制。远处转移是影响患者预后的重要因素。
