鼻窦未分化癌（SNUC）的治疗结果及失败模式：梅奥诊所经验
Outcomes and patterns of failure for sinonasal undifferentiated carcinoma (SNUC): The Mayo Clinic Experience.
作者信息
Gamez Mauricio E, Lal Devyani, Halyard Michele Y, Wong William W, Vargas Carlos, Ma Daniel, Ko Stephen J, Foote Robert L, Patel Samir H
机构信息
Department of Radiation Oncology, Mayo Clinic, Phoenix, Arizona.
Department of Otolaryngology, Mayo Clinic, Phoenix, Arizona.
出版信息
Head Neck. 2017 Sep;39(9):1819-1824. doi: 10.1002/hed.24834. Epub 2017 May 31.
BACKGROUND
Sinonasal undifferentiated carcinoma (SNUC) is a rare aggressive disease arising in the nasal cavity and paranasal sinuses with poor prognosis and unclear optimal management.
METHODS
Forty patients were analyzed. Nasal cavity was the most common primary site. Most patients presented with T4 disease, received trimodality therapy, and were treated with intensity-modulated radiotherapy (IMRT).
RESULTS
Median follow-up was 6.9 years. Sixteen patients (40%) experienced recurrent disease, 5 local (12.5%), 1 regional (2.5%), and 10 distant (25%). The 5-year overall survival (OS), recurrence-free survival (RFS), and locoreginal control (LRC) were 44%, 39%, and 71%, respectively. Patients treated with trimodality therapy had better outcomes compared to single modality therapy. Improved OS was noted with IMRT and with doses ≥60 Gy. The most common cause of death was distant metastasis.
CONCLUSION
SNUC is an aggressive malignancy with a high tendency to metastasize. Better outcomes were obtained with a trimodality approach. Modern radiotherapy (RT) techniques and doses ≥ 60 Gy were associated with improved OS.
背景
鼻腔鼻窦未分化癌（SNUC）是一种罕见的侵袭性疾病，发生于鼻腔和鼻窦，预后较差，最佳治疗方案尚不明确。
方法
对40例患者进行分析。鼻腔是最常见的原发部位。大多数患者表现为T4期疾病，接受了三联疗法，并采用调强放射治疗（IMRT）。
结果
中位随访时间为6.9年。16例患者（40%）出现疾病复发，5例为局部复发（12.5%），1例为区域复发（2.5%），10例为远处复发（25%）。5年总生存率（OS）、无复发生存率（RFS）和局部区域控制率（LRC）分别为44%、39%和71%。与单一疗法相比，接受三联疗法的患者预后更好。IMRT和剂量≥60 Gy可提高OS。最常见的死亡原因是远处转移。
结论
SNUC是一种具有高转移倾向的侵袭性恶性肿瘤。三联疗法可获得更好的预后。现代放疗（RT）技术和剂量≥60 Gy与OS改善相关。
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