Ono Takeharu, Tanaka Norimitsu, Umeno Hirohito, Sakata Kiyohiko, Morioka Motohiro, Ohmaru Yoko, Rikimaru Hideaki, Koga Noriyuki, Kiyokawa Kensuke, Chitose Shun-Ichi, Shin Buichiro, Aso Takeichiro, Etoh Hidehiro, Abe Toshi
aDepartment of Otolaryngology - Head and Neck Surgery, Kurume University School of Medicine, Kurume, Japan.
bDepartment of Radiology, Kurume University School of Medicine, Kurume, Japan.
Case Rep Oncol. 2017 Apr 18;10(1):339-349. doi: 10.1159/000470834. eCollection 2017 Jan-Apr.
We retrospectively analyzed 14 patients with locally advanced squamous cell carcinoma of ethmoid sinus (LASCC-ES) for the feasibility of anterior craniofacial resection (ACFR). Ethmoid cancer treatment comprised alternating chemoradiotherapy (ALCRT; = 1), concomitant radiotherapy and intra-arterial cisplatin (RADPLAT; = 4) and ACFR ( = 9). The 3- and 5-year overall survival (OS) rates of patients were 47.6 and 39.6%, respectively. The 3-year local control (LC) rates of chemoradiotherapy (CRT; ALCRT and RADPLAT) ( = 5) and ACFR ( = 9) groups were 0 and 66.7% ( = 0.012), respectively. The 3-year progression-free survival (PFS) rate of the CRT and ACFR groups were 0 and 55.6% ( = 0.018), respectively. The 3-year OS rate of the CRT and ACFR groups were 0 and 76.2% ( = 0.005), respectively. Postoperative pathological examinations confirmed positive margins in 3 (33%) of 9 cases. The 3-year LC and PFS rates of cases ( = 3) with positive surgical margins were significantly poorer than those of cases ( = 6) with negative surgical margins. Although ACFR for LASCC-ES is a feasible treatment, cases with positive surgical margins were more prone to local relapse. Therefore, surgical safety margins should be thoroughly assessed.
我们回顾性分析了14例筛窦局部晚期鳞状细胞癌(LASCC-ES)患者,以评估前颅面切除术(ACFR)的可行性。筛窦癌的治疗方法包括交替放化疗(ALCRT;n = 1)、同步放疗和动脉内顺铂化疗(RADPLAT;n = 4)以及ACFR(n = 9)。患者的3年和5年总生存率(OS)分别为47.6%和39.6%。放化疗(CRT;ALCRT和RADPLAT)组(n = 5)和ACFR组(n = 9)的3年局部控制率(LC)分别为0和66.7%(P = 0.012)。CRT组和ACFR组的3年无进展生存率(PFS)分别为0和55.6%(P = 0.018)。CRT组和ACFR组的3年OS率分别为0和76.2%(P = 0.005)。术后病理检查证实9例中有3例(33%)切缘阳性。手术切缘阳性病例(n = 3)的3年LC和PFS率明显低于手术切缘阴性病例(n = 6)。虽然ACFR治疗LASCC-ES是一种可行的治疗方法,但手术切缘阳性的病例更容易局部复发。因此,应全面评估手术安全切缘。