Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.
Department of Radiation Oncology, Prince of Wales Hospital, Sydney, New South Wales, Australia.
J Med Imaging Radiat Oncol. 2020 Jun;64(3):450-459. doi: 10.1111/1754-9485.13034. Epub 2020 Apr 20.
Sinonasal carcinomas (SNCs) are rare neoplasms that are often diagnosed at advanced stages due to asymptomatic growth of tumours in the spaces of the sinonasal complex. Treatment is associated with high morbidity, and outcomes have only improved slightly in the past few decades despite advancements in treatment modalities. The purpose of this study is to evaluate the efficacy and safety of treatment at our institution.
This retrospective cohort study analysed patients who received definitive treatment at the Prince of Wales Hospital (POWH), Sydney, for non-metastatic SNC. Patients with non-carcinoma and olfactory neuroblastoma pathology were excluded. Data were collected from the POWH electronic patient database. Survival functions were calculated through Kaplan-Meier analysis, and multivariate analysis for prognostic factors was performed through Cox regression.
Seventy-five patients from 1994 to 2016 were eligible for analysis. Overall 5-year local control (LC), ultimate local control (ULC), overall survival (OS) and cancer-specific survival (CSS) were 76 ± 6%, 80 ± 5%, 69 ± 6% and 77 ± 5%, respectively. On multivariate analysis, clinical stage was prognostic for LC and primary site was prognostic for OS and CSS. Lymphovascular invasion and tumour inoperability were also predictive of CSS.
Survival and local control rates at our centre were greater than those reported in the literature. Early-stage patients treated with surgery alone had excellent oncologic outcomes. Radical surgery with postoperative radiation provides the best outcome in the setting of advanced disease.
鼻窦癌(SNC)是一种罕见的肿瘤,由于鼻窦复合体腔隙中肿瘤的无症状生长,通常在晚期诊断。治疗相关的发病率较高,尽管治疗方式有所进步,但在过去几十年中,治疗效果仅略有改善。本研究旨在评估我们机构的治疗效果和安全性。
这项回顾性队列研究分析了在悉尼王子亲王医院(POWH)接受非转移性 SNC 确定性治疗的患者。排除了非癌和嗅神经母细胞瘤病理患者。数据来自 POWH 电子患者数据库。通过 Kaplan-Meier 分析计算生存函数,并通过 Cox 回归进行预后因素的多变量分析。
1994 年至 2016 年期间,有 75 名患者符合分析条件。总体 5 年局部控制(LC)、最终局部控制(ULC)、总生存(OS)和癌症特异性生存(CSS)分别为 76±6%、80±5%、69±6%和 77±5%。多变量分析显示,临床分期与 LC 相关,原发部位与 OS 和 CSS 相关。脉管侵犯和肿瘤不可切除性也是 CSS 的预测因素。
我们中心的生存率和局部控制率高于文献报道。单独接受手术治疗的早期患者具有极好的肿瘤学结果。在晚期疾病中,根治性手术加术后放疗提供了最佳结果。