Sinonasal undifferentiated carcinoma: The search for a better outcome
Sinonasal undifferentiated carcinoma: The search for a better outcome
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DOI：
10.1097/00005537-200208000-00023
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发表时间：
2002-08-01
期刊：
影响因子：
2.6
通讯作者：
Levine, PA
中科院分区：
文献类型：
--
作者：
Musy, PY;Reibel, JF;Levine, PA
目的：评价规范化治疗鼻腔鼻窦未分化癌（SNUC）的临床疗效。研究设计：单中心、回顾性病例系列。研究方法：1991年至2000年，弗吉尼亚大学耳鼻咽喉头颈外科收治了15例新诊断的SNUC患者。还分析了1986年至1991年诊断的另外5例患者的长期随访。结果：总的来说，10例患者接受了新辅助放化疗后颅面切除术（CFR）的根治性治疗。其余大部分患者仅接受姑息性放疗或放化疗。4例接受CFR的患者目前在术后4、36、49和164个月时无疾病。所有可评估患者的2年生存率（无论治疗与否）为47%。CFR治疗组的2年生存率为64%，化疗和/或放疗组为25%（P = 0.076）。结论：对于表现状态良好且颅内或眶内病变有限的患者，我们继续提倡先进行放化疗，然后进行颅面切除术。由于晚期疾病而被认为不可手术的患者可能仅通过放化疗而经历显著的缓解。
Objective: To evaluate the clinical outcomes of a standardized treatment approach for sinonasal undifferentiated carcinoma (SNUC). Study Design: Single-center, retrospective case series. Methods: Fifteen patients with newly diagnosed SNUC were seen in the Department of Otolaryngology-Head and Neck Surgery at the University of Virginia from 1991 to 2000. Long-term follow-up on five additional patients diagnosed between 1986 and 1991 was also analyzed. Results: Overall, 10 patients were treated with curative intent with neoadjuvant chemoradiotherapy followed by craniofacial resection (CFR). The majority of the remainder was treated with palliative radiotherapy or chemoradiotherapy alone. Four patients who underwent CFR are currently free of disease at 4, 36, 49, and 164 months postoperatively. The 2-year survival of all evaluable patients, regardless of treatment, was 47%. Two-year survival was 64% in the group treated by CFR and 25% in the group treated with chemo- and/or radiotherapy (P = .076). Conclusion: For patients with good performance status and limited intracranial or intraorbital disease, we continue to advocate initial chemoradiotherapy followed by craniofacial resection. Patients who are deemed inoperable as a result of advanced disease may nevertheless experience significant palliation with chemoradiotherapy only.