鼻腔嗅神经母细胞瘤11例临床分析

目的 回顾分析鼻腔嗅神经母细胞瘤的放疗疗效.方法 1974～1994年鼻腔嗅神经母细胞瘤11例,其中B期6例,C期5例.单纯放疗6例,术后放疗5例.3例术后无肿瘤肉眼残留者照射剂量D_T45Gy～55Gy/23～28次共4.5～5.5周.其余8例照射剂量D_T均在60Gy/30次共6周以上.3例颈淋巴结转移者照射剂量D_T60Gy～65Gy/30～33次共6～7周.结果 本组病例三、五年生存率分别为55%、36%,单纯放疗组分别为33%、17%,术后放疗组分别为80%、60%.P值0.2727,二组在统计学上无显著差异.全组病例中3例局部复发,2例血行转移.结论 B、C期患者根治性手术加术后放疗为局部控制的较好治疗方案.

CLINICAL ANALYSIS OF 11 PATIENTS WITH OLFACTORY NEUROBLASTOMA

PURPOSETo analyze the role of radiotherapy in the treatment of olfactory neuroblastoma. METHODS From 1974 to 1994. 11 patients with olfactory neuroblastoma were treated in Xinjiang Cancer Hospital. All patients were confirmed histologically. Six cases were stage B and 5, stage C. Five patients were treated with surgery and postoperative radiotherapy (4. stage B and 1, stage C), and 6. with radiotherapy alone. The tumor dose ranged from 45~68 Gy, 2. 0 Gy/Fx. Neck irradiation with total dose of 60~65 Gy was carried out for 3 patients with cervical lymph node metastases. RESULTS Three patients had local recurrences and 2 cases, distant metastases. The actuarial overall survivals at 3 and 5 year were 55% and 36%, respectively. Three and five year survivals were 33%and 17% for the patients treated with radiotherapy alone, and 80% and 60% for the patients treated with surgery and postoperative irradiation, respectively(P= 0. 2727). CONCLUSION For the patients with stage B and C olfactory neuroblastoma, combined modality of surgery and radiotherapy should be the treatment of choice.