Antonello M, Polico R, Botner F, Cazzato G, Piccolo L, Pizzi G B
Divisione di Radioterapia Oncologica, Ospedale Civile Umberto l, Mestre.
Acta Otorhinolaryngol Ital. 1996 Aug;16(4):347-54.
The authors evaluate 32 patients affected by paranasal sinuses and nasal cavity carcinoma observed at Orl-Rt Department of Oncologic Center at Umberto l(zero) Hospital in Mestre (VE), Italy from 1985 to 1994. Among these: 16 maxillary sinus, 10 ethmoid and 6 nasal cavity carcinomas. Histologic diagnosis showed squamous cell carcinoma in 15 cases, adenocarcinoma in 8 cases, lymphoma in 2 cases, transitional cell carcinoma in 2 cases, undifferentiated carcinoma in 2 cases and adenoidocistic carcinoma in 3 cases. The mean age was 64.5 years (range 46-88 years), and mean performance status was 80 (range 60-90). Four patients had lymphonodal involvement. Eleven patients were operated, eight of them radically. All patients were treated with radiation therapy. Treatment planning was performed using Theraplan V05-B program, on extensive number of CT scans. The minimal tumor dose was 50 Gy for patients operated radically and was 60 Gy with maximum of 73-80 Gy for the others. The follow-up is 39.7 months (range 10-108). Three patients treated with radical surgery developed local relapses, two of them died. Fourteen patients treated with non radical or diagnostic surgery and radiotherapy obtained local complete remission, five of them developed local relapses inside treatment volume. Ten patients died (eight for neoplastic disease). The 3 years, 5-years and 7-years overall survival are respectively 72% and 51%. The 5-years and 7-years disease free survival rate are respectively 48% and 19% with median at 3.7 years. Complication have been minimal. Only one patient affected by glaucoma had a severe and permanent reduction of the virus. The authors conclude that 2D and 3D treatment planning can assure a better accuracy for target definition and a better precision of the treatment with a reduction of complications.
作者评估了1985年至1994年期间在意大利梅斯特雷（威尼斯）翁贝托一世医院肿瘤中心耳鼻喉科观察到的32例受鼻窦和鼻腔癌影响的患者。其中：上颌窦癌16例，筛窦癌10例，鼻腔癌6例。组织学诊断显示，鳞状细胞癌15例，腺癌8例，淋巴瘤2例，移行细胞癌2例，未分化癌2例，腺样囊性癌3例。平均年龄为64.5岁（范围46 - 88岁），平均体能状态为80（范围60 - 90）。4例有淋巴结受累。11例患者接受了手术，其中8例为根治性手术。所有患者均接受放射治疗。使用Theraplan V05 - B程序，根据大量CT扫描进行治疗计划。根治性手术患者的最小肿瘤剂量为50 Gy，其他患者为60 Gy，最大剂量为73 - 80 Gy。随访时间为39.7个月（范围10 - 108个月）。3例接受根治性手术的患者出现局部复发，其中2例死亡。14例接受非根治性或诊断性手术及放疗的患者获得局部完全缓解，其中5例在治疗区域内出现局部复发。10例患者死亡（8例死于肿瘤疾病）。3年、5年和7年总生存率分别为72%和51%。5年和7年无病生存率分别为48%和19%，中位无病生存期为3.7年。并发症极少。仅1例青光眼患者出现严重且永久性视力下降。作者得出结论，二维和三维治疗计划能够确保靶区定义更准确，治疗精度更高，同时减少并发症。
