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[嗅神经母细胞瘤治疗的初步经验与探讨]

[Primary experience and discussion on the treatment of esthesioneuroblastoma].

作者信息

Jiang L J, Lin T J, Huang Z Q, Zuo K J, Zhang Y, Shi J B, Lai Y Y

机构信息

Department of Otorhinolaryngology, Otorhinolaryngology Hospital, First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510800, China.

Department of Radiationoncology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510405, China.

出版信息

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Jul 7;56(7):719-723. doi: 10.3760/cma.j.cn115330-20200605-00479.

Abstract

To summarize the preliminary experience in the treatment of esthesioneuroblastoma (ENB) and to explore the effect of age, chemotherapy, modified Kadish stage and pathological grade on the prognosis of ENB. The clinical data of 87 ENB patients from the First Affiliated Hospital of Sun Yat-sen University and Sun Yat-sen University Cancer Center between June 2002 and November 2017 were retrospectively analyzed. The modified Kadish stage was used to evaluate the extent of the lesions, and the Hyams grading system was used for pathological grading. The patients were followed up regularly to evaluate the recurrence and metastasis of the tumor. Cox proportional hazard model was used for univariate and multivariate analyses. Prognostic factors with <0.05 in univariate analysis were included in multivariate analysis. After controlling the confounding factors, the model coefficients were used to calculate the hazard ratio (HR) and 95% confidence interval (CI). The median follow-up time of ENB patients was 29 months, and the 5-year overall survival rate was 39.3%. In univariate analysis, age, chemotherapy, modified Kadish stage and pathology grade were independent predictors of overall survival, while gender, radiotherapy and surgery were not prognostic factors. Multivariate analysis showed that modified Kadish stage and pathology grade were independent predictors of overall survival rate after excluding confounding factors. Age, chemotherapy, modified Kadish stage and pathological grade are taking important role in the overall survival rate of patients with ENB. Modified Kadish stage and pathological grade are independent predictors of overall survival rate.

摘要

总结嗅神经母细胞瘤(ENB)的治疗初步经验,并探讨年龄、化疗、改良Kadish分期及病理分级对ENB预后的影响。回顾性分析2002年6月至2017年11月间中山大学附属第一医院和中山大学肿瘤防治中心收治的87例ENB患者的临床资料。采用改良Kadish分期评估病变范围,采用Hyams分级系统进行病理分级。对患者进行定期随访,评估肿瘤的复发和转移情况。采用Cox比例风险模型进行单因素和多因素分析。单因素分析中P<0.05的预后因素纳入多因素分析。在控制混杂因素后,利用模型系数计算风险比(HR)和95%置信区间(CI)。ENB患者的中位随访时间为29个月,5年总生存率为39.3%。单因素分析中,年龄、化疗、改良Kadish分期和病理分级是总生存的独立预测因素,而性别、放疗和手术不是预后因素。多因素分析显示,排除混杂因素后,改良Kadish分期和病理分级是总生存率的独立预测因素。年龄、化疗、改良Kadish分期和病理分级对ENB患者的总生存率有重要影响。改良Kadish分期和病理分级是总生存率的独立预测因素。

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