中华放射肿瘤学杂志
中華放射腫瘤學雜誌
중화방사종류학잡지
CHINESE JOURNAL OF RADIATION ONCOLOGY
2015年
5期
534-538
,共5页
尹珍珍%高黎%罗京伟%易俊林%黄晓东%王凯%曲媛%张世平%李素艳%肖建平%徐国镇
尹珍珍%高黎%囉京偉%易俊林%黃曉東%王凱%麯媛%張世平%李素豔%肖建平%徐國鎮
윤진진%고려%라경위%역준림%황효동%왕개%곡원%장세평%리소염%초건평%서국진
嗅神经母细胞瘤/放射疗法%治疗结果%失败模式
嗅神經母細胞瘤/放射療法%治療結果%失敗模式
후신경모세포류/방사요법%치료결과%실패모식
Eeshesineuroblastoma/radiotherapy%Treatment outcomes%Failure pattern
目的：分析嗅神经母细胞瘤单中心的治疗疗效及失败模式。方法回顾性分析本院1979—2014年间初诊112例无远处转移嗅神经母细胞瘤病例，改良Kadish分期A期1例、B期23例、C期60例、D期28例。手术＋术后放疗±化疗者51例，放疗±化疗者46例，术前放疗＋手术±化疗者11例，手术±化疗者3例，单纯化疗者1例。 Kaplan?Meier 法计算生存率。结果全组5年样本数44例，5年OS和DFS分别为66％和55％，术前放疗＋手术±化疗者分别为91％和82％，手术＋术后放疗±化疗者分别为80％和66％，放疗±化疗者分别为46％和37％。3例单纯手术均出现复发，1例姑息化疗者生存时间为6个月。全组共47例治疗失败，失败率为42％，以远处转移为首次失败方式者占总失败的53％、局部区域复发占36％、同时存在局部区域复发及远处转移者为11％。结论嗅神经母细胞瘤治疗仍推荐放疗＋手术综合治疗方案。综合治疗模式下嗅神经母细胞瘤局部区域控制率及疗效尚可，主要失败方式为远处转移。
目的：分析嗅神經母細胞瘤單中心的治療療效及失敗模式。方法迴顧性分析本院1979—2014年間初診112例無遠處轉移嗅神經母細胞瘤病例，改良Kadish分期A期1例、B期23例、C期60例、D期28例。手術＋術後放療±化療者51例，放療±化療者46例，術前放療＋手術±化療者11例，手術±化療者3例，單純化療者1例。 Kaplan?Meier 法計算生存率。結果全組5年樣本數44例，5年OS和DFS分彆為66％和55％，術前放療＋手術±化療者分彆為91％和82％，手術＋術後放療±化療者分彆為80％和66％，放療±化療者分彆為46％和37％。3例單純手術均齣現複髮，1例姑息化療者生存時間為6箇月。全組共47例治療失敗，失敗率為42％，以遠處轉移為首次失敗方式者佔總失敗的53％、跼部區域複髮佔36％、同時存在跼部區域複髮及遠處轉移者為11％。結論嗅神經母細胞瘤治療仍推薦放療＋手術綜閤治療方案。綜閤治療模式下嗅神經母細胞瘤跼部區域控製率及療效尚可，主要失敗方式為遠處轉移。
목적：분석후신경모세포류단중심적치료료효급실패모식。방법회고성분석본원1979—2014년간초진112례무원처전이후신경모세포류병례，개량Kadish분기A기1례、B기23례、C기60례、D기28례。수술＋술후방료±화료자51례，방료±화료자46례，술전방료＋수술±화료자11례，수술±화료자3례，단순화료자1례。 Kaplan?Meier 법계산생존솔。결과전조5년양본수44례，5년OS화DFS분별위66％화55％，술전방료＋수술±화료자분별위91％화82％，수술＋술후방료±화료자분별위80％화66％，방료±화료자분별위46％화37％。3례단순수술균출현복발，1례고식화료자생존시간위6개월。전조공47례치료실패，실패솔위42％，이원처전이위수차실패방식자점총실패적53％、국부구역복발점36％、동시존재국부구역복발급원처전이자위11％。결론후신경모세포류치료잉추천방료＋수술종합치료방안。종합치료모식하후신경모세포류국부구역공제솔급료효상가，주요실패방식위원처전이。
Objective To evaluate the multimodal treatment outcomes and patterns of treatment failure in esthesioneuroblastoma at a single institution. Methods One hundred and twelve patients who were newly diagnosed with esthesioneuroblastoma but no distant metastasis in our institution from 1979 to 2014 were retrospectively analyzed. The treatment modes, outcomes, and patterns of treatment failure in these patients were analyzed. According to the modified Kadish staging system, the numbers of patients with stage A, B, C, and D esthesioneuroblastoma were 1, 23, 60, and 28, respectively. Fifty?one patients received surgery and postoperative radiotherapy with or without chemotherapy;forty?six patients received radiotherapy with or without chemotherapy;eleven patients received preoperative radiotherapy and surgery with or without chemotherapy;three patients received surgery with or without chemotherapy; one patient received chemotherapy alone. The survival rates were calculated using the Kaplan?Meier method. Results In all patients, the 5?year sample size was 44, and the 5?year overall survival ( OS ) and disease?free survival ( DFS) rates were 66?4% and 54?7%, respectively. The 5?year OS and DFS rates were 91% and 82% in patients who received preoperative radiotherapy and surgery with or without chemotherapy, 80% and 66% in patients who received surgery and postoperative radiotherapy with or without chemotherapy, and 46% and 37% in patients who received radiotherapy with or without chemotherapy. Three patients treated with surgery alone had relapse of the disease;one patient treated with palliative chemotherapy survived 6 months. Treatment failed in 47 ( 42%) out of 112 patients. In patients with failed treatment, 53% had distant metastasis as the first pattern of treatment failure, 36% had locoregional relapse, and 11% had concurrent distant metastasis and locoregional relapse. Conclusions Surgery combined with radiotherapy is still the recommended multimodal treatment regimen for esthesioneuroblastoma. The multimodal treatment achieves satisfactory local?regional control rate and treatment outcomes in the treatment of esthesioneuroblastoma. The major pattern of treatment failure is distant metastasis.
