ESTHESIONEUROBLASTOMA - THE ROLE OF ADJUVANT RADIATION-THERAPY
ESTHESIONEUROBLASTOMA - THE ROLE OF ADJUVANT RADIATION-THERAPY
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DOI：
10.1016/0360-3016(93)90457-7
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发表时间：
1993-11-15
影响因子：
7
通讯作者：
OFALLON, WM
中科院分区：
文献类型：
--
作者：
FOOTE, RL;MORITA, A;OFALLON, WM
目的：我们描述了我们的经验与辅助放射治疗的患者接受手术的嗅神经母细胞瘤。方法和材料：1951年1月至1990年12月，49例嗅神经母细胞瘤接受了他们的初步治疗在马约诊所。有27名男性和22名女性患者;他们的年龄范围为3至79岁（中位数，54岁）。Kadish A期4例，B期13例，C期29例，改良Kadish D期3例（颈淋巴结或远处转移）。肿瘤按Hyams分级。治疗包括22例单纯大体全切除术和16例大体全切除术和术后辅助放疗。结果：5年生存率、无瘤生存率和局部控制率分别为69.1% ± 7.0%、54.8% ± 7.6%和65.3% ± 7.4%。Hyams分级是总生存期、无病生存期和局部控制的唯一重要预测因子。接受术后辅助放疗的患者局部控制得到改善，即使这组患者的肿瘤更晚期和更高级别（5年局部控制率为85.9% ± 9.3%，而单纯手术组为72.7% ± 9.5%，p = 0.26）。嗅神经母细胞瘤的辅助放射治疗可改善局部肿瘤控制，特别是高级别和高分期肿瘤。我们建议在嗅神经母细胞瘤完全切除后再行放射治疗（55.5戈伊）。
Purpose: We describe our experience with adjuvant radiation therapy in patients who underwent operation for esthesioneuroblastoma.Methods and Materials: Between January 1951 and December 1990, 49 patients with esthesioneuroblastoma received their initial treatment at the Mayo Clinic. There were 27 male and 22 female patients; their ages ranged from 3 to 79 years (median, 54 years). The tumors were Kadish Stage A in 4 patients, Stage B in 13, Stage C in 29, and modified Kadish Stage D in three (cervical nodal or distant metastasis). The tumors were graded according to Hyams' classification. Treatment included gross total resection alone in 22 patients and gross total resection and postoperative adjuvant radiation therapy in 16. The patients treated with adjuvant radiation had a greater proportion of advanced-stage and high-grade tumors.Results: The 5-year actuarial overall survival, disease-free survival, and local control rates were 69.1% + 7.0%, 54.8% + 7.6%, and 65.3% + 7.4%, respectively. The only significant predictor for overall survival, disease-free survival, and local control was Hyams' grade. Local control was improved in patients who received postoperative adjuvant radiation even though this group of patients had more advanced and higher-grade tumors (5-year rate of local control was 85.9% + 9.3%, compared with 72.7% + 9.5% for those who had operation alone, p = 0.26).Conclusion: Adjuvant radiation therapy for esthesioneuroblastoma improves local tumor control, particularly for high-grade and high-stage tumors. We recommend additional treatment with radiation (55.5 Gy) after complete resection of esthesioneuroblastoma.