Almeyda R, Capper J
Department of Otolaryngology, Wexham Park Hospital, Berks, UK.
Clin Otolaryngol. 2008 Oct;33(5):435-41. doi: 10.1111/j.1749-4486.2008.01790.x.
Woodworkers' adenocarcinoma of the ethmoid sinuses is an extremely rare occupational malignancy with a locally aggressive course. Treatment with surgical exenteration and topical 5 fluorouracil (5FU) packs has become standard treatment over the last 10 years in this ENT unit. This study presents level 2 evidence that 5FU provides improved survival over previous management with primary radiotherapy and salvage craniofacial resection.
Retrospective case series with historical control group.
District General Hospital.
The records of 31 consecutive patients with the disease were analysed. Five patients died prior to treatment. One patient was treated with surgery alone and therefore excluded. Twenty-five patients were included in the analysis. Fourteen were treated with primary radiotherapy and 11 with surgery and topical 5FU.
Disease free survival was measured using Kaplan-Meier survival analysis.
Five-year disease free survival improved from 50% with primary radiotherapy to 86% with surgery and 5FU. This improvement is statistically significant (P = 0.03).
Topical 5FU treatment improves survival of Woodworker's adenocarcinoma of the ethmoid sinuses. This finding may be useful in the treatment of other locally aggressive sinonasal malignancies.
木工筛窦腺癌是一种极其罕见的职业性恶性肿瘤，病程呈局部侵袭性。在过去10年里，该耳鼻喉科单位采用手术扩大切除联合局部5-氟尿嘧啶（5FU）包敷治疗已成为标准治疗方法。本研究提供了二级证据，表明与先前的单纯放疗及挽救性颅面切除术相比，5FU可提高生存率。
带有历史对照组的回顾性病例系列研究。
区综合医院。
对连续31例该病患者的记录进行分析。5例患者在治疗前死亡。1例患者仅接受手术治疗，因此被排除。纳入分析的患者有25例。14例接受单纯放疗，11例接受手术及局部5FU治疗。
采用Kaplan-Meier生存分析评估无病生存期。
5年无病生存率从单纯放疗的50%提高到手术联合5FU治疗的86%。这一改善具有统计学意义（P = 0.03）。
局部5FU治疗可提高木工筛窦腺癌的生存率。这一发现可能对其他局部侵袭性鼻窦恶性肿瘤的治疗有帮助。
