Zhang C G, Zhou S Y, Liu P, Qin Y, Yang J L, He X H, Shi Y K
National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Anticancer Drug Clinical Study, Beijing 100021, China.
Zhonghua Yi Xue Za Zhi. 2018 Sep 11;98(34):2722-2726. doi: 10.3760/cma.j.issn.0376-2491.2018.34.009.
To analyze the clinical characteristics and prognosis of newly diagnosed localized head and neck rhabdomyosarcoma. Cases of newly diagnosed localized head and neck rhabdomyosarcoma between January 2006 and December 2016 were analyzed retrospectively. The clinical features of the patients were described. The Kaplan-Meier method was used to analyze the survival rate under different combined modality therapy and the survival rate with or without chemotherapy. The prognostic factors were analyzed by Cox model. A total of 46 patients were included in this study. Among them, the median follow-up time was 77 months and the median relapse free survival time was 13 months. The relapse free survival time of 5 cases with inadequate local treatment and without combined chemotherapy was 5 months as control, and it was 7 months (=0.110) in 11 cases with adequate local treatment without combined chemotherapy. Then in 7 cases with inadequate local treatment combined with chemotherapy and 23 cases with adequate local treatment combined with chemotherapy, it was 13 months (=0.007) and 21 months (<0.001), respectively. The median relapse-free survival time of chemotherapy patients was significantly longer than that of those without chemotherapy (21 vs 6 months, =0.018). The effect of combined modality therapy was evaluated according to the adequacy of local treatment and whether to receive systemic chemotherapy, and the combined modality therapy degree was the independent prognostic factor in Cox's proportional hazards regression model (=0.004). Rhabdomyosarcoma in head and neck is a highly malignant tumor with high relapse rate and easy metastasis. In patients with tolerable condition, systemic chemotherapy and adequate combined modality therapy are recommended to improve relapse-free survival.
分析新诊断的局限性头颈部横纹肌肉瘤的临床特征及预后。回顾性分析2006年1月至2016年12月期间新诊断的局限性头颈部横纹肌肉瘤病例。描述患者的临床特征。采用Kaplan-Meier法分析不同综合治疗方式下的生存率以及化疗与否的生存率。通过Cox模型分析预后因素。本研究共纳入46例患者。其中,中位随访时间为77个月,中位无复发生存时间为13个月。5例局部治疗不充分且未接受联合化疗患者的无复发生存时间为5个月作为对照,11例局部治疗充分但未接受联合化疗患者的无复发生存时间为7个月(P=0.110)。7例局部治疗不充分联合化疗患者和23例局部治疗充分联合化疗患者的无复发生存时间分别为13个月(P=0.007)和21个月(P<0.001)。化疗患者的中位无复发生存时间显著长于未化疗患者(21个月对6个月,P=0.018)。根据局部治疗的充分性以及是否接受全身化疗评估综合治疗的效果,综合治疗程度是Cox比例风险回归模型中的独立预后因素(P=0.004)。头颈部横纹肌肉瘤是一种高度恶性肿瘤,复发率高且易转移。对于身体状况可耐受的患者,建议进行全身化疗及充分的综合治疗以提高无复发生存率。