头颈部皮肤癌伴神经周围侵犯。

Skin carcinoma of the head and neck with perineural invasion.

机构信息

Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, USA.

出版信息

Am J Otolaryngol. 2012 Jul-Aug;33(4):447-54. doi: 10.1016/j.amjoto.2011.11.004. Epub 2011 Dec 19.

DOI:10.1016/j.amjoto.2011.11.004

PMID:22185685

Abstract

PURPOSE

The aim of the study was to update the experience treating cutaneous squamous cell and basal cell carcinomas of the head and neck with incidental or clinical perineural invasion (PNI) with radiotherapy (RT).

MATERIALS AND METHODS

From 1965 to 2007, 216 patients received RT alone or with surgery and/or chemotherapy.

RESULTS

The 5-year overall, cause-specific, and disease-free survivals for incidental and clinical PNIs were 55% vs 54%, 73% vs 64%, and 67% vs 51%. The 5-year local control, local-regional control, and freedom from distant metastases for incidental and clinical PNIs were 80% vs 54%, 70% vs 51%, and 90% vs 94%. On univariate and multivariate (P = .0038 and .0047) analyses, clinical PNI was a poor prognostic factor for local control. The rates of grade 3 or higher complication in the incidental and clinical PNI groups were 16% and 36%, respectively.

CONCLUSIONS

Radiotherapy plays a critical role in the treatment of this disease. Clinical PNI should be adequately irradiated to include the involved nerves to the skull base.

摘要

目的

本研究旨在更新头颈部皮肤鳞状细胞癌和基底细胞癌伴偶然或临床神经周围侵犯（PNI）的治疗经验，采用放射治疗（RT）。

材料与方法

1965 年至 2007 年，216 例患者单独接受 RT 或手术联合化疗/放疗。

结果

偶然和临床 PNI 的 5 年总生存率、疾病特异性生存率和无病生存率分别为 55%比 54%、73%比 64%和 67%比 51%。偶然和临床 PNI 的 5 年局部控制率、局部区域控制率和无远处转移率分别为 80%比 54%、70%比 51%和 90%比 94%。单因素和多因素分析（P =.0038 和.0047）显示，临床 PNI 是局部控制的不良预后因素。偶然和临床 PNI 组的 3 级或更高级别并发症发生率分别为 16%和 36%。