Schmerber S, Righini Ch, Soriano E, Delalande C, Dumas G, Reyt E, Lavieille J P
CHRU Grenoble, Service d'Oto-Rhino-Laryngologie, F-38043 Grenoble 09, France.
Rev Laryngol Otol Rhinol (Bord). 2005;126(3):165-70.
A retrospective analysis of management and survival of patients treated for temporal bone carcinoma.
Thirty patients underwent treatment for carcinoma of the temporal bone. Twenty-five squamous cell carcinomas, 1 melanoma, 2 basocellular carcinomas and 2 adenoid cystic carcinomas were treated. Thirteen patients were treated before for the same disease.
Staging revealed 12 T1 and T2, 6 T3 and 12 T4 tumours. The mean follow up was 5 years (2-276 months). The Kaplan Meier survival curves showed survival rates at 2 years of 82%, 67% and 32%, and at 5 years of 82%, 67% and 17%, respectively for the stages T1 or T2, T3 and T4. At the end of follow up at 9 years the survival rates were 66%, 66% and 17% for the stages T1 or T2, T3 and T4 respectively. Overall stages a complete remission was found in 65% and 23%, and deceased was 35% and 77%, respectively for the primary treatment group and the salvage surgery group.
Long-term prognosis of the carcinoma of the external auditory canal mainly depends on the stage and primary treatment. Surgery (lateral temporal bone or subtotal temporal bone resection, both in combination with a neck dissection and a parotidectomy) and adjuvant radiotherapy is the treatment of choice for part of stage T1 and all T2 and T3 tumours. The improved survival (65%) of patients treated de novo compared with those treated with salvage surgery (23%) suggests that early referral and aggressive primary surgical treatment with postoperative radiotherapy offer the greatest chance of cure.
对颞骨癌患者的治疗及生存情况进行回顾性分析。
30例患者接受了颞骨癌治疗。其中包括25例鳞状细胞癌、1例黑色素瘤、2例基底细胞癌和2例腺样囊性癌。13例患者曾因同一疾病接受过治疗。
分期显示有12例T1和T2期、6例T3期和12例T4期肿瘤。平均随访时间为5年（2至276个月）。Kaplan-Meier生存曲线显示，T1或T2期、T3期和T4期患者在2年时的生存率分别为82%、67%和32%，在5年时分别为82%、67%和17%。随访9年结束时，T1或T2期、T3期和T4期患者的生存率分别为66%、66%和17%。总体而言，在初次治疗组和挽救性手术组中，完全缓解率分别为65%和23%，死亡率分别为35%和77%。
外耳道癌的长期预后主要取决于分期和初次治疗。手术（外侧颞骨切除术或颞骨次全切除术，均联合颈部清扫术和腮腺切除术）及辅助放疗是部分T1期和所有T2期及T3期肿瘤的首选治疗方法。与挽救性手术治疗的患者（23%）相比，初治患者生存率提高（65%），这表明早期转诊及积极的初次手术治疗并术后放疗提供了最大的治愈机会。
