Outcomes of nonsurgical management of locally advanced carcinomas of the sinonasal cavity.
Outcomes of nonsurgical management of locally advanced carcinomas of the sinonasal cavity.
复制标题
DOI：
10.1002/lary.26228
复制
发表时间：
2017-04
期刊：
影响因子：
--
通讯作者：
Yoo G
中科院分区：
文献类型：
--
作者：
Chopra S;Kamdar DP;Cohen DS;Heilbrun LK;Smith D;Kim H;Lin HS;Jacobs JR;Yoo G
确定铂类同步放化疗治疗局部晚期鼻窦癌的结局。回顾性队列分析了1998年7月至2009年2月诊断的23例非手术和明确治疗的患者。腺样囊性癌或腺癌患者接受光子和中子治疗;其他组织学仅接受光子治疗。绝大多数人接受了化疗。使用描述性统计量，并计算Kaplan-Meier估计值。观察到女性（57%）和高加索人（74%）占优势。87%是不可切除的;上颌窦和鼻筛窦部位同样普遍。分别有74%和70%的患者使用调强放射治疗（IMRT）和单独使用光子。95%的化疗患者使用铂类药物。在64%的患者中观察到完全缓解。中位无进展生存期（PFS）和总生存期（OS）分别为28.8和65.3个月。3年PFS和OS率分别为44%和72%; 5年PFS和OS率分别为30%和60%。调强放射治疗和上颌起始部位显示出上级PFS的趋势;高剂量方案与较短的PFS相关。在59%的患者中观察到复发，主要是局部复发。几乎没有非预期不良反应-未报告IV/V级事件。晚期鼻腔鼻窦癌是一种放化疗敏感的肿瘤，尽管局部复发的倾向很高。调强放射治疗有明确的适应症，铂类为主的放化疗方案有潜在的治疗作用。
To determine the outcome of definitive concurrent chemoradiation with platinum for locally advanced sinonasal carcinomas. Retrospective cohort 23 nonsurgically and definitively treated patients diagnosed between July 1998 and February 2009 were analyzed. Patients with adenoid cystic carcinoma or adenocarcinoma were treated with photons and neutrons; the other histologies received photons alone. The vast majority received chemotherapy. Descriptive statistics were utilized, and Kaplan-Meier estimates were computed. Female (57%) and Caucasian (74%) preponderance were observed. Eighty seven percent were unresectable; the maxillary and naso-ethmoid sites were equally prevalent. Intensity-modulated radiation therapy (IMRT) and photons alone were utilized in 74% and 70%, respectively. Platinum agents were given in 95% of chemotherapy patients. Complete response was observed in 64% of patients. Median progression-free survival (PFS) and overall survival (OS) were 28.8 and 65.3, months respectively. Three-year PFS and OS rates were 44% and 72%, respectively; 5-year PFS and OS rates were 30% and 60%, respectively. IMRT and a maxillary site of origin showed a trend towards superior PFS; higher-dose regimens were associated with somewhat shorter PFS. Relapse was observed in 59% of patients, predominantly local. There were few unanticipated adverse effects- no Grade IV/V events were reported. Advanced sinonasal carcinomas are chemoradiosensitive tumors, albeit with a high propensity for local relapse. There is a definite indication for IMRT and a potential curative role of platinum-based chemoradiation regimens.