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与鼻窦恶性肿瘤治疗相关的长期并发症:单中心经验。

Long-term complications associated with the management of sinonasal malignancies: a single center experience.

机构信息

Department of Otolaryngology - Head and Neck Surgery, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel.

Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

出版信息

Acta Otorhinolaryngol Ital. 2023 Jun;43(3):203-211. doi: 10.14639/0392-100X-N1902.

Abstract

OBJECTIVE

The aim of this study was to review the long-term complications associated with treatment of patients with sinonasal malignancies (SNMs) and risk factors for these complications.

METHODS

A retrospective analysis of all patients treated for SNMs at a tertiary care center between 2001 and 2018. A total of 77 patients were included. The primary outcome measure was post-treatment long-term complications.

RESULTS

Overall, long-term complications were identified in 41 patients (53%), and the most common were sinonasal (22 patients, 29%) and orbital/ocular-related (18 patients, 23%). In a multivariate regression analysis, irradiation was the only significant predictor of long-term complications (p = 0.001, OR = 18.86, CI = 3.31-107.6). No association was observed between long-term complications and tumour stage, surgical modality, or radiation dose/modality. Mean radiation dose ≥ 50 Gy to the optic nerve was associated with grade ≥ 3 visual acuity impairment (100% 3%; p = 0.006). Radiation therapy for disease recurrence was associated with additional long-term complications (56% 11%; p = 0.04).

CONCLUSIONS

Treatment of SNMs has substantial long-term complications, which are significantly associated with radiation therapy.

摘要

目的

本研究旨在回顾与治疗鼻腔鼻窦恶性肿瘤(SNM)相关的长期并发症及其危险因素。

方法

对 2001 年至 2018 年间在一家三级护理中心接受 SNM 治疗的所有患者进行回顾性分析。共纳入 77 例患者。主要结局指标为治疗后长期并发症。

结果

共有 41 例(53%)患者出现长期并发症,最常见的是与鼻腔鼻窦(22 例,29%)和眼眶/眼相关(18 例,23%)的并发症。多变量回归分析显示,放疗是长期并发症的唯一显著预测因素(p=0.001,OR=18.86,CI=3.31-107.6)。长期并发症与肿瘤分期、手术方式或放疗剂量/方式无相关性。视神经接受≥50Gy 的平均放射剂量与≥3 级视力损害相关(100%[3%];p=0.006)。针对疾病复发的放疗与额外的长期并发症相关(56%[11%];p=0.04)。

结论

SNM 的治疗存在严重的长期并发症,且与放疗密切相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ab8f/10198366/b69345a56758/aoi-2023-03-203-g001.jpg

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