Sinonasal inverted papilloma associated with squamous cell carcinoma
Sinonasal inverted papilloma associated with squamous cell carcinoma
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DOI：
10.2478/v10019-011-0033-4
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发表时间：
2011-12-01
影响因子：
2.4
通讯作者：
Strojan, Primoz
中科院分区：
文献类型：
--
作者：
But-Hadzic, Jasna;Jenko, Klemen;Strojan, Primoz
背景资料。该研究的目的是回顾鼻窦内翻性乳头状瘤合并鳞状细胞癌(IP/SCC)的单一机构经验，分析HPV的存在，并评估放射治疗的作用。在前瞻性机构数据库(1995-2005)中确定了5名IP/SCC患者，并在所有5个肿瘤中确定了HPV状态。五分之四的患者患有T3-4肿瘤；其中任何一例均未见结节受累。4名患者接受了根治性手术，其中3名患者辅以放射治疗。对于不能切除的肿瘤患者进行去髓核手术，然后进行根治性放射治疗。术后8个月、46个月和58个月3例肿瘤局部控制。局部失败发生在两位患者：一位是在内窥镜下切除T1肿瘤(复发的肿瘤通过额外的手术成功挽救)，另一位是不能手术的肿瘤患者。未发生区域性或远处转移。5例肿瘤均为HPV阳性，其中3例HPV11型阳性。对于可手术的鼻腔IP/SCC，建议采用与侵袭性SCC相当的剂量水平的术前手术和术后肿瘤床放射治疗。对于不能切除的疾病，根治性放射治疗66-70Gy可能是有益的。
Background. The aims of the study were to review single-institution experiences with sinonasal inverted papilloma associated with squamous cell carcinoma (IP/SCC), to analyze the presence of human papillomavirus (HPV) and to evaluate the role of radiotherapy.Patients and methods. Five patients with IP/SCC were identified in the prospective institutional databases (1995-2005) and HPV status was determined in all five tumors.Results. Four out of five patients had T3-4 tumors; no nodal involvement was seen in any of them. Four patients had curative surgery, supplemented in three of them with radiotherapy. Debulking surgery was performed in the patient with a non-resectable tumor followed by radical radiotherapy. Tumor was controlled locally in three patients at 8, 46 and 58 months post-surgery. Local failure occurred in two patients: after endoscopic resection of a T1 tumor (the recurrent tumor was successfully salvaged with additional surgery) and in a patient with an inoperable tumor. No regional or distant metastases occurred. HPV status was determined in all five tumors and three of them were found positive for HPV type 11.Conclusions. In operable sinonasal IP/SCC, upfront surgery and postoperative radiotherapy to the tumor bed with dose levels comparable to those used for invasive SCC are recommended. For non-resectable disease, radical radiotherapy to a dose of 66-70 Gy could be of benefit.