Prasad S, Janecka I P
Eye and Ear Institute of Pittsburgh, University of Pittsburgh School of Medicine.
Otolaryngol Head Neck Surg. 1994 Mar;110(3):270-80. doi: 10.1177/019459989411000303.
A review of all publications dealing with surgical treatment for squamous cell carcinomas of the temporal bone was performed. No randomized or nonrandomized control studies were identified. All studies were case series without control subjects. Twenty-six of 96 publications, which contained information on 144 patients, were analyzed. Several inferences are suggested by the available evidence; however, these areas should be investigated by properly designed randomized clinical trials: (1) patients with carcinoma that is confined to the external auditory canal have similar survival, regardless of whether mastoidectomy, lateral temporal bone resection (TBR), or subtotal TBR is performed: the addition of radiation therapy to lateral TBR does not appear to improve survival; (2) when disease extends into the middle ear, survival of patients treated with subtotal TBR appeared to be improved over those treated with lateral TBR or mastoidectomy: it remains uncertain if the addition of radiation therapy to mastoidectomy improves survival; (3) the value of surgical resection when carcinoma extends to involve the petrous apex remains unclear; (4) resection of involved dura mater does not appear to improve survival; however, incomplete data regarding margins of resection were reported; and (5) determination of the value of resection of involved brain parenchyma or internal carotid artery will require further study.
我们对所有涉及颞骨鳞状细胞癌手术治疗的出版物进行了综述。未发现随机对照或非随机对照研究。所有研究均为无对照受试者的病例系列。对96篇出版物中的26篇进行了分析，这些出版物包含了144例患者的信息。现有证据提出了一些推论；然而，这些领域应通过设计合理的随机临床试验进行研究：（1）局限于外耳道的癌患者，无论进行乳突切除术、颞骨外侧切除术（TBR）还是次全TBR，其生存率相似：在外侧TBR基础上加用放射治疗似乎并不能提高生存率；（2）当疾病扩展至中耳时，接受次全TBR治疗的患者生存率似乎高于接受外侧TBR或乳突切除术的患者：乳突切除术加用放射治疗是否能提高生存率仍不确定；（3）当癌扩展累及岩尖时，手术切除的价值仍不清楚；（4）切除受累硬脑膜似乎并不能提高生存率；然而，关于切除切缘的数据不完整；（5）确定切除受累脑实质或颈内动脉的价值需要进一步研究。
