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累及眼眶的鼻窦恶性肿瘤的治疗结果

Treatment Outcomes of Sinonasal Malignancies Involving the Orbit.

作者信息

Shin Chul Ho, Lee Ho Jun, Chung Yoo-Sam, Kim Ji Heui

机构信息

Department of Otorhinolaryngology-Head and Neck Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.

出版信息

J Neurol Surg B Skull Base. 2021 May 29;83(Suppl 2):e430-e437. doi: 10.1055/s-0041-1730353. eCollection 2022 Jun.

Abstract

Orbital invasion is associated with a poor prognosis in cases of sinonasal malignancy. This study aimed to analyze the oncological outcomes of sinonasal malignancies involving the orbit.  We reviewed the medical records of 116 patients with a sinonasal malignancy who had orbital invasion at initial diagnosis and followed up at least 6 months between June 1991 and October 2017 at a single institute. The overall survival (OS), disease-specific survival (DSS), and progression-free survival (PFS) rates according to the clinicopathological factors, extent to orbit, and treatment modality were compared.  Patients were mainly treated with surgery and postoperative radiation (  = 39, 33.6%) and concurrent chemoradiation (  = 72, 62.1%). Only five patients (5.1%) underwent orbital exenteration. The OS, DSS, and PFS rates significantly decreased in patients older than 60 years of age and in patients with a higher Charlson Comorbidity Index Score (each  < 0.001). The OS and DSS rates were higher in patients at clinical T3 and N0 stage than in patients at clinical T4 and N1-2 stage (each  < 0.05). There were no significant differences in survival and local control rates according to the extent of orbital invasion, treatment modalities, and orbital preservation. However, neoadjuvant chemotherapy and adjuvant radiation or concurrent chemoradiation increased survival rates in the patients treated with surgery.  Orbit preservation and relatively successful oncological outcome could be obtained with surgery and adjuvant radiation or concurrent chemoradiation.

摘要

鼻窦恶性肿瘤侵犯眼眶与预后不良相关。本研究旨在分析累及眼眶的鼻窦恶性肿瘤的肿瘤学结局。

我们回顾了1991年6月至2017年10月期间在单一机构初诊时侵犯眼眶且随访至少6个月的116例鼻窦恶性肿瘤患者的病历。比较了根据临床病理因素、眼眶侵犯范围和治疗方式的总生存(OS)、疾病特异性生存(DSS)和无进展生存(PFS)率。

患者主要接受手术及术后放疗(n = 39,33.6%)和同步放化疗(n = 72,62.1%)。仅5例患者(5.1%)接受了眼眶内容物剜除术。60岁以上患者以及Charlson合并症指数评分较高的患者的OS、DSS和PFS率显著降低(均P < 0.001)。临床T3和N0期患者的OS和DSS率高于临床T4和N1 - 2期患者(均P < 0.05)。根据眼眶侵犯范围、治疗方式和眼眶保留情况,生存和局部控制率无显著差异。然而,新辅助化疗和辅助放疗或同步放化疗提高了接受手术治疗患者的生存率。

通过手术及辅助放疗或同步放化疗可实现眼眶保留并获得相对良好的肿瘤学结局。

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