A comprehensive comparative analysis of treatment modalities for sinonasal malignancies.
A comprehensive comparative analysis of treatment modalities for sinonasal malignancies.
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DOI：
10.1002/cncr.30686
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发表时间：
2017-08-15
期刊：
影响因子：
6.2
通讯作者：
Karam SD
中科院分区：
文献类型：
--
作者：
Robin TP;Jones BL;Gordon OM;Phan A;Abbott D;McDermott JD;Goddard JA;Raben D;Lanning RM;Karam SD
鼻窦恶性肿瘤是一种罕见且异质性的肿瘤，缺乏可靠的数据来指导管理决策。作者使用国家癌症数据库来更好地了解这些肿瘤的表现特征，并比较不同治疗方式的结果。国家癌症数据库查询了2004年至2012年间诊断出的鼻窦恶性肿瘤。使用多变量分析和倾向评分匹配评估总生存率。初步分析共确定了11160例患者。多数为男性，年龄40 ~ 69岁，鼻腔或上颌窦肿瘤。鳞状细胞组织学最常见。大多数患者表现为肿瘤晚期，但没有局部区域淋巴结或远处转移。比较了鳞状细胞癌的治疗方式。在多因素分析中，与单纯手术相比，接受辅助放疗（危险比[HR]， 0.658 [P<.001]）、辅助放化疗（危险比[HR]， 0.696 [P=.002]）或新辅助治疗（危险比，0.656 [P=. 007]）的患者总生存率均有提高。单纯放疗组（HR, 1.294 [P=.001]）或单纯化疗组（HR, 1.834 [P<.001]）预后较差。这些发现在倾向评分匹配中得到了验证。值得注意的是，新辅助放化疗与获得负手术切缘相关（优势比为2.641 [P= 0.045]）。手术是鼻窦恶性肿瘤患者的主要治疗方法，但多模式治疗可提高总生存率。
Sinonasal malignancies are a rare and heterogeneous group of tumors for which there is a paucity of robust data with which to guide management decisions. The authors used the National Cancer Data Base to better understand the presenting characteristics of these tumors and to compare outcomes by treatment modality. The National Cancer Data Base was queried for sinonasal malignancies diagnosed between 2004 and 2012. Overall survival was assessed using multivariate analyses and propensity score matching. A total of 11,160 patients were identified for the initial analysis. The majority were male, aged 40 to 69 years, with tumors of the nasal cavity or maxillary sinus. Squamous cell histology was most common. The majority of patients presented with advanced tumor stage but without locoregional lymph node or distant metastases. Treatment modalities were compared for squamous cell carcinomas. In multivariate analysis, compared with surgery alone, patients who received adjuvant radiotherapy (hazard ratio [HR], 0.658 [P<.001]), adjuvant chemoradiotherapy (HR, 0.696 [P=.002]), or neoadjuvant therapy (HR, 0.656 [P = .007]) had improved overall survival. Patients who received radiotherapy alone (HR, 1.294 [P=.001]) or chemotherapy alone (HR, 1.834 [P<.001]) had worse outcomes. These findings were validated in propensity score matching. It is important to note that neoadjuvant chemoradiotherapy was associated with achieving a negative surgical margin (odds ratio, 2.641 [P=.045]). Surgery is the mainstay of therapy for patients with sinonasal malignancies, but multimodality therapy is associated with improved overall survival.
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DOI：
10.4317/medoral.21170
发表时间：
2016-09-01
期刊：
Medicina oral, patologia oral y cirugia bucal
影响因子：
--
作者：
Danesh-Sani SA;Sarafraz A;Chamani M;Derakhshandeh H
通讯作者：
Derakhshandeh H
影响因子：
--
作者：
Mannu GS;Iyer NG;Shah J
通讯作者：
Shah J
影响因子：
7.2
作者：
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通讯作者：
CIOL, MA
DOI：
10.1016/j.ijrobp.2016.02.019
发表时间：
2016-05-01
影响因子：
7
作者：
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通讯作者：
Mendenhall, William M.
影响因子：
4.8
作者：
Amini, Arya;Jasem, Jagar;Karam, Sana D.
通讯作者：
Karam, Sana D.