Zhang Zong-min, Tang Ping-zhang, Xu Zhen-gang, Li Zheng-jiang
Department of Head and Neck Surgery, Cancer Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing 100021, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2010 Jul;45(7):555-9.
To evaluate the treatment outcome of different therapeutic modalities for squamous cell carcinoma of the nose and ethmoid sinus and prognostic factors.
One hundred and forty-six cases of squamous cell carcinoma of the nose and ethmoid sinus treated from 1990 to 2007 were reviewed. Of the 146 cases, 28 were at stage I or II; 46 stage III; 72 stage IV. Forty-one patients were treated with preoperative radiation plus surgery (R + S), 22 patients with surgery plus postoperative radiation (S + R), 5 patients with surgery alone (SA), 78 patients with radiotherapy alone (RA).
The overall 5 year survival rate of 146 patients with squamous cell carcinoma of the nose and ethmoid sinus was 49.1%. The 5 year survival rate of the patients at stage I and II was 95.7%, while the rate was 59.8% in the patients at stage III and 28.2% in the patients at stage IV (χ(2) = 24.15, P < 0.05). The 5 year survival rate was 57.7% in R + S group, 60.4% in S + R group, 100% in SA group, and 38.8% in RA group, respectively (P > 0.05). The 5 years survival rate of N+ patients was lower than that of N0 (χ(2) = 12.326, P < 0.05). Local recurrence and distant metastasis were main causes of death. Cox analysis showed TNM stage and differentiation of tumor were independent significant prognostic factors.
The higher survival rate of patients with squamous cell carcinoma of the nose and ethmoid sinus was obtained from combined therapy R + S or S + R. SA gave ideal results for early lesions (stage I and II).
评估鼻及筛窦鳞状细胞癌不同治疗方式的治疗效果及预后因素。
回顾性分析1990年至2007年期间收治的146例鼻及筛窦鳞状细胞癌患者。其中，Ⅰ或Ⅱ期28例；Ⅲ期46例；Ⅳ期72例。41例患者接受术前放疗加手术（R + S），22例患者接受手术加术后放疗（S + R），5例患者仅接受手术（SA），78例患者仅接受放疗（RA）。
146例鼻及筛窦鳞状细胞癌患者的5年总生存率为49.1%。Ⅰ和Ⅱ期患者的5年生存率为95.7%，Ⅲ期患者为59.8%，Ⅳ期患者为28.2%（χ(2)=24.15，P < 0.05）。R + S组5年生存率为57.7%，S + R组为60.4%，SA组为100%，RA组为38.8%（P > 0.05）。N+患者的5年生存率低于N0患者（χ(2)=12.326，P < 0.05）。局部复发和远处转移是主要死亡原因。Cox分析显示TNM分期和肿瘤分化是独立的显著预后因素。
鼻及筛窦鳞状细胞癌患者采用R + S或S + R联合治疗可获得较高生存率。SA对早期病变（Ⅰ和Ⅱ期）效果理想。
