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采用前颅面切除术或放化疗治疗的筛窦局部晚期鳞状细胞癌的治疗结果

Treatment Outcomes of Locally Advanced Squamous Cell Carcinoma of the Ethmoid Sinus Treated with Anterior Craniofacial Resection or Chemoradiotherapy.

作者信息

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

机构信息

aDepartment of Otolaryngology - Head and Neck Surgery, Kurume University School of Medicine, Kurume, Japan.

bDepartment of Radiology, Kurume University School of Medicine, Kurume, Japan.

出版信息

Case Rep Oncol. 2017 Apr 18;10(1):339-349. doi: 10.1159/000470834. eCollection 2017 Jan-Apr.

Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/af3e/5436010/bb34cfa11cfe/cro-0010-0339-g01.jpg

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