De Bonnecaze Guillaume, Lepage B, Rimmer J, Al Hawat A, Vairel B, Serrano E, Chaput B, Vergez S
Otolaryngology, Head and Neck Surgery Department, University Hospital Rangueil-Larrey, 24 Chemin de Pouvourville, 31059, Toulouse, France.
Epidemiology Unit, University of Toulouse, Toulouse, France.
Eur Arch Otorhinolaryngol. 2016 Jan;273(1):21-6. doi: 10.1007/s00405-014-3320-z. Epub 2014 Oct 17.
Surgical resection followed by radiotherapy can be considered like the optimal treatment modality for limited esthesioneuroblastoma. However, therapeutic management of locally advanced tumors remains a challenge. The aim of our study was to access and compare the oncologic results of the different treatment modalities in advanced esthesioneuroblastoma. We performed a systematic review using the Medline, and Cochrane database in accordance with PRISMA criteria and included all the cases of advanced esthesioneuroblastoma published between 2000 and 2013. We also retrospectively included 15 patients with an advanced esthesioneuroblastoma managed at our tertiary care medical center. Long-term survival rates defined as the time from diagnosis or randomization to the date of death or last follow-up were evaluated for each treatment with Kaplan-Meier survival curve analyses. 283 patients have been included. The mean follow-up was 78 months. Five-year highest survival rates were obtained in patients treated by surgery associated with radiotherapy. Ten-year highest survival rates were obtained in patients treated by the association of surgery, radiotherapy and chemotherapy (p = 0.0008). Within the surgical group, 5-year highest survival rates were obtained in patients treated by endoscopic resection (p = 0.003). Surgical resection combined with radiotherapy offers the gold standard of care. Adjuvant chemotherapy seems to improve the long-term survival in patients with locally advanced esthesioneuroblastoma. Endoscopic resection in advanced tumors should be discussed on a case-by-case basis.
手术切除后进行放疗可被视为局限性嗅神经母细胞瘤的最佳治疗方式。然而，局部晚期肿瘤的治疗管理仍然是一项挑战。我们研究的目的是评估和比较晚期嗅神经母细胞瘤不同治疗方式的肿瘤学结果。我们按照PRISMA标准使用Medline和Cochrane数据库进行了系统评价，纳入了2000年至2013年间发表的所有晚期嗅神经母细胞瘤病例。我们还回顾性纳入了在我们三级医疗中心接受治疗的15例晚期嗅神经母细胞瘤患者。通过Kaplan-Meier生存曲线分析对每种治疗方法的长期生存率进行评估，长期生存率定义为从诊断或随机分组到死亡日期或最后随访的时间。共纳入283例患者。平均随访时间为78个月。接受手术联合放疗的患者获得了最高的5年生存率。接受手术、放疗和化疗联合治疗的患者获得了最高的10年生存率（p = 0.0008）。在手术组中，接受内镜切除的患者获得了最高的5年生存率（p = 0.003）。手术切除联合放疗提供了护理的金标准。辅助化疗似乎能提高局部晚期嗅神经母细胞瘤患者的长期生存率。晚期肿瘤的内镜切除应逐案讨论。
