20例成人嗅神经母细胞瘤综合治疗的临床分析

[Clinical analysis of 20 adults esthesioneuroblastoma with combined therapy].

作者信息

Li Ji-shi, Xie Fang-yun, Peng Miao, Han Fei

机构信息

State Key Laboratory of Oncology in South China, Department of Radiation Oncology, Cancer Center, Sun Yat-sen University, Guangzhou 510060, China.

出版信息

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2009 Jan;44(1):36-9.

DOI:
Abstract

OBJECTIVE

To retrospectively compare the survival difference of 20 patients with esthesioneuroblastoma (EN) who received combined therapy, and try to analyze the most optimized modalities.

METHODS

Twenty patients of adult ( > or = 14 years) EN received combined therapy in Cancer Center of Sun Yat-sen University from Jan 1998 to Jan 2005. Six patients were staged Kadish B and fourteen patients Kadish C. Twelve of them received induction chemotherapy followed by radiotherapy while the other 8 received surgery followed by adjuvant radiotherapy. The disease free survival and overall survival rate were calculated by Kaplan-Meier method and compared by Log-rank method. And the baseline characteristics was examined by Fisher's exact test.

RESULTS

Follow up from beginning of treatment to 31th March, 2008, the 3-year overall survival rate was 50.0%, the 3-year disease free survival and overall survival rates were 16.7%, 25.0% for chemoradiation group and 75.0%, 87.5% for surgery plus radiotherapy group, respectively. The disease free survival and overall survival rate of the latter group were better than the former (chi2 values were 6.81 and 7.33, P values were 0.0091 and 0.0068, respectively).

CONCLUSIONS

Surgery combined with adjuvant radiotherapy may increase the survival rate compared with induction chemotherapy followed by radiotherapy for local advanced esthesioneuroblastoma. Active surgery combined with radiotherapy and chemotherapy may further improve the survival of EN.

摘要

目的

回顾性比较20例接受联合治疗的嗅神经母细胞瘤(EN)患者的生存差异,并尝试分析最优化的治疗方式。

方法

1998年1月至2005年1月,20例成年(≥14岁)EN患者在中山大学肿瘤防治中心接受联合治疗。其中6例为Kadish B期,14例为Kadish C期。12例患者先接受诱导化疗再行放疗,另外8例患者先接受手术再行辅助放疗。采用Kaplan-Meier法计算无病生存率和总生存率,并用Log-rank法进行比较。通过Fisher精确检验检查基线特征。

结果

从治疗开始至2008年3月31日进行随访,3年总生存率为50.0%,放化疗组的3年无病生存率和总生存率分别为16.7%、25.0%,手术加放疗组分别为75.0%、87.5%。后一组的无病生存率和总生存率均优于前一组(χ2值分别为6.81和7.33,P值分别为0.0091和0.0068)。

结论

对于局部晚期嗅神经母细胞瘤,与先诱导化疗再放疗相比,手术联合辅助放疗可能提高生存率。积极的手术联合放疗和化疗可能进一步提高嗅神经母细胞瘤患者的生存率。

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