Moskovic Daniel J, Smolarz Joseph R, Stanley Douglas, Jimenez Camilo, Williams Michelle D, Hanna Ehab Y, Kupferman Michael E
Scott Department of Urology, Baylor College of Medicine, Houston, Texas, USA.
Head Neck Oncol. 2010 Sep 23;2:23. doi: 10.1186/1758-3284-2-23.
Little is known about management and prognosis for malignant head & neck paragangliomas. We reviewed records of these patients to determine optimal treatment strategies.
We reviewed 113 cases of head & neck paragangliomas treated at our institution from 1970 to 2005. Nineteen patients were included in the study. All had primary surgical treatment at another institution. Metastatic disease was treated with radiation, chemotherapy, or both. Survival and complications were evaluated. P values were determined by Fischer's exact test.
All patients treated with chemotherapy and radiation age ≥ 40 years had disease progression. Of the patients < 40, two had stable disease; one had regression of disease with treatment. Patients without disease progression had better prognosis and were alive at last follow-up.
Clinical benefit was derived from aggressive treatment. However, careful consideration of the risks of observation versus intensive therapy should be undertaken when managing these patients.
关于恶性头颈部副神经节瘤的治疗及预后，人们了解甚少。我们回顾了这些患者的记录，以确定最佳治疗策略。
我们回顾了1970年至2005年在我院接受治疗的113例头颈部副神经节瘤患者。19例患者纳入研究。所有患者均在其他机构接受了初次手术治疗。转移性疾病采用放疗、化疗或两者联合治疗。评估生存情况及并发症。P值通过费舍尔精确检验确定。
所有年龄≥40岁且接受化疗和放疗的患者均出现疾病进展。年龄<40岁的患者中，2例病情稳定；1例经治疗后病情缓解。无疾病进展的患者预后较好，在最后一次随访时仍存活。
积极治疗可带来临床获益。然而，在管理这些患者时，应仔细权衡观察与强化治疗的风险。
