Mark R J, Sercarz J A, Tran L, Dodd L G, Selch M, Calcaterra T C
Department of Radiation Oncology, UCLA Medical Center 90024.
Arch Otolaryngol Head Neck Surg. 1991 Jul;117(7):761-6. doi: 10.1001/archotol.1991.01870190073015.
Eighteen cases of osteogenic sarcoma of the head and neck were treated at our institution between 1955 and 1987. The patients' ages ranged from 5 to 73 years, with a median age of 28 years. The sex distribution was equal. Follow-up ranged from 1 to 276 months, with a median of 79 months. The primary site of the tumor was the mandible in nine cases, maxilla and paranasal sinuses in six, skull in two, and orbit in one. Six of 18 patients were free of disease with greater than 5 years of follow-up. Four of the six received combined surgery, radiation therapy, and chemotherapy as their primary treatment. Of the five patients treated with surgery alone, four suffered recurrences, one of whom was salvaged with further surgery and chemotherapy. Five patients were treated initially without surgery. They received radiation therapy with or without chemotherapy; all five developed local recurrence. We conclude that osteogenic sarcoma of the head and neck is an aggressive tumor, prone to both local and distant failure. Based on our series and from published experience involving the extremities, osteogenic sarcoma of the head and neck should be managed with multimodality therapy.
1955年至1987年间，我院共治疗了18例头颈部骨肉瘤患者。患者年龄从5岁至73岁不等，中位年龄为28岁。性别分布均衡。随访时间从1个月至276个月不等，中位随访时间为79个月。肿瘤的原发部位：9例位于下颌骨，6例位于上颌骨和鼻窦，2例位于颅骨，1例位于眼眶。18例患者中有6例在随访超过5年后无疾病复发。这6例中的4例接受了手术、放疗和化疗联合作为初始治疗。在仅接受手术治疗的5例患者中，4例复发，其中1例通过进一步手术和化疗挽救。5例患者最初未接受手术治疗。他们接受了放疗，部分联合化疗；所有5例均出现局部复发。我们得出结论，头颈部骨肉瘤是一种侵袭性肿瘤，易于出现局部和远处复发。基于我们的病例系列以及已发表的有关四肢骨肉瘤的经验，头颈部骨肉瘤应采用多模式治疗。
