成年人鼻腔鼻窦横纹肌肉瘤的临床疗效分析

发布时间：2018-04-09 20:47

本文选题：鼻腔鼻窦肿物　切入点：横纹肌肉瘤　出处：《临床耳鼻咽喉头颈外科杂志》2015年09期

【摘要】：目的:探讨影响成年人鼻腔鼻窦横纹肌肉瘤(SNRMS)临床预后的因素。方法:回顾性分析2006-01-2014-12期间收治的23例成年(年龄18岁)SNRMS患者的临床资料。用Kaplan-Meier法进行生存分析,组间比较采用Log-rank检验,多因素分析采用Cox模型。结果:23例患者平均随访20个月,死亡14例,存活9例。全组病例1年和2年生存率分别为77.1%和35.0%。组间1年和2年生存率分析显示,TNM分期中2、3期分别为100.0%、66.7%和83.3%、10.5%(P0.05);综合治疗组和单独治疗组分别为86.7%、50.0%和50.8%、0(P0.05)。21例初诊非远处转移组,1年和2年远处转移率分别为38.1%和70.5%。COX多因素生存分析发现接受放疗、化疗和肿瘤直径5cm是SNRMS的预后良好因素;而淋巴结转移、肿瘤累及脑膜和眶内是SNRMS的预后不良因素。14例死亡患者中,1例死于局部侵犯脑膜脑组织,1例死于局部区域复发伴远处转移,12例死于远处转移。结论:成年SNRMS就诊时多晚期,预后差,远处转移是主要的死亡原因,控制远处转移率是提高生存率的关键。
[Abstract]:Objective: to investigate the prognostic factors of nasal sinus rhabdomyosarcoma (SNRMS) in adults.Methods: the clinical data of 23 patients with SNRMS aged 18 years from January to December 2014 were retrospectively analyzed.Kaplan-Meier method was used for survival analysis, Log-rank test was used for intergroup comparison, and Cox model was used for multivariate analysis.Results 23 patients were followed up for an average of 20 months, 14 died and 9 survived.The 1-and 2-year survival rates were 77.1% and 35.0%, respectively.Survival analysis revealed radiation therapy,Chemotherapy and tumor diameter 5cm were good prognostic factors of SNRMS, and lymph node metastasis,Tumor involvement in meninges and orbit is the prognostic factor of SNRMS. 1 case died of local invasion of meningeal brain tissue, 1 case died of local regional recurrence with distant metastasis 12 cases died of distant metastasis.Conclusion: in adult SNRMS, the prognosis is poor, and distant metastasis is the main cause of death. The key to improve the survival rate is to control the distant metastasis rate.
【作者单位】：教育部重点实验室(首都医科大学)首都医科大学附属北京同仁医院耳鼻咽喉头颈外科;首都医科大学附属北京同仁医院病理科;首都医科大学附属北京同仁医院肿瘤科;
【基金】：北京市科委首都临床特色应用研究项目(No:Z121107001012003) 北京市卫生系统高层次卫生技术人才培养计划(No:2013-03-054)
【分类号】：R739.62

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