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辅助化疗在接受手术和辅助放疗治疗嗅神经母细胞瘤的患者中的应用。

Utility of adjuvant chemotherapy in patients receiving surgery and adjuvant radiotherapy for primary treatment of esthesioneuroblastoma.

机构信息

Mayo Clinic School of Medicine, Mayo Clinic, Rochester, Minnesota.

Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota.

出版信息

Head Neck. 2019 May;41(5):1335-1341. doi: 10.1002/hed.25558. Epub 2018 Dec 10.

Abstract

BACKGROUND

Past research established that surgery plus adjuvant radiotherapy (S + AR) improves overall survival (OS) in esthesioneuroblastoma (ENB). However, it is unknown if the addition of adjuvant chemotherapy (AC) further improves survival. The primary objective of this study was to compare survival among patients treated with S + AR alone to patients who underwent S + AR + AC.

METHODS

Retrospective review of patient records.

RESULTS

Thirty-eight patients met inclusion criteria for either S + AR or S + AR + AC treatment groups. The S + AR + AC group contained more patients with Kadish stage D disease, dural invasion, and positive histologic margins postsurgery. All S + AR + AC patients received platinum-based regimens, combined with etoposide in 67%. OS and recurrence-free survival did not differ between the two groups, even when restricting the analysis to patients with Kadish stages B and C disease.

CONCLUSION

Patients who received platinum-based AC did not exhibit improved survival compared to S + AR alone. Further investigation, preferably prospective, into the optimal use of systemic therapy in ENB is warranted.

摘要

背景

过去的研究表明,手术加辅助放疗(S+AR)可改善鼻腔神经母细胞瘤(ENB)患者的总生存率(OS)。然而,辅助化疗(AC)的加入是否能进一步提高生存率尚不清楚。本研究的主要目的是比较单纯 S+AR 治疗与 S+AR+AC 治疗的患者的生存情况。

方法

回顾性分析患者病历。

结果

38 名患者符合 S+AR 或 S+AR+AC 治疗组的纳入标准。S+AR+AC 组中 Kadish 分期 D 期、硬脑膜侵犯和术后组织学切缘阳性的患者更多。所有 S+AR+AC 患者均接受铂类为基础的方案治疗,其中 67%的患者联合使用依托泊苷。两组之间的 OS 和无复发生存率没有差异,即使在将分析仅限于 Kadish 分期 B 和 C 期的患者中也是如此。

结论

与单纯 S+AR 治疗相比,接受铂类 AC 治疗的患者并未表现出更好的生存。需要进一步进行前瞻性研究,以确定在 ENB 中系统治疗的最佳应用。

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