临床特征与预后因素的鼻窦未分化癌：一项多中心研究。

Clinical characteristics and prognostic factors of sinonasal undifferentiated carcinoma: a multicenter study.

机构信息

Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Rangueil-Larrey, Toulouse, France.

Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Lariboisière, Paris, France.

出版信息

Int Forum Allergy Rhinol. 2018 Sep;8(9):1065-1072. doi: 10.1002/alr.22143. Epub 2018 Jun 23.

DOI:10.1002/alr.22143

PMID:29935059

Abstract

BACKGROUND

Sinonasal undifferentiated carcinoma (SNUC) is a very rare entity with a poor prognosis. Due to the lack of studies on the subject, evidence is lacking concerning its management.

METHODS

A multicenter collaborative study was conducted to assess treatment strategy, oncological outcome, and prognostic factors.

RESULTS

Definitive analyses focused on 54 patients with a majority of advanced stage; the 3-year overall survival (OS) and 3-year recurrence-free survival (RFS) rates were, respectively, 62.4% and 47.8%. During the follow-up, 18 patients (33.3%) died, 10 (18.5%) developed metastases, 7 had lymph-node involvement (13%), and 12 (22.2%) showed recurrence or local progression. In univariate analyses, treatment modalities associated with improved RFS were induction chemotherapy (p = 0.02) and intensity-modulated radiotherapy (p = 0.007). In the multivariate analyses, only induction chemotherapy (p = 0.047, hazard ratio [HR] = 0.39) was significantly associated with improved RFS.

CONCLUSION

Multimodal therapies including induction chemotherapy and intensity-modulated radiotherapy may improve the prognosis of SNUC; surgery might improve local control. Further multicenter studies are required.

摘要

背景

嗅神经母细胞瘤（SNUC）是一种非常罕见的实体瘤，预后较差。由于缺乏对此类疾病的研究，其治疗管理缺乏证据。

方法

进行了一项多中心协作研究，以评估治疗策略、肿瘤学结果和预后因素。

结果

明确分析集中在 54 例晚期患者；3 年总生存率（OS）和 3 年无复发生存率（RFS）分别为 62.4%和 47.8%。在随访期间，18 例患者（33.3%）死亡，10 例（18.5%）发生转移，7 例有淋巴结受累（13%），12 例（22.2%）出现复发或局部进展。单因素分析显示，诱导化疗（p=0.02）和调强放疗（p=0.007）与 RFS 改善相关。多因素分析显示，只有诱导化疗（p=0.047，风险比[HR]为 0.39）与 RFS 的改善显著相关。