12例嗅神经母细胞瘤的临床分析

Olfactory Neuroblastoma:A Clinical Analysis of 12 Cases

目的探讨嗅神经母细胞瘤的临床特点及治疗。方法对12例嗅神经母细胞瘤患者的临床资料进行回顾性分析。所有患者均采用肿瘤切除术和42～70 Gy放疗治疗,部分加用化疗。结果表现为鼻塞者有11例,占91.7%,颈淋巴结或远处转移者9例,占75.0%。所有患者均接受手术切除术治疗(8例行根治术,4例行非根治性手术)和42～70 Gy的放疗,5例患者手术后行4～6周期化疗。12例患者均获随访,中位生存期为63(6～120)个月,其中A期1例至今存活,B期1例存活5年以上,C期有1例存活5年以上,3例存活3年。结论嗅神经母细胞瘤恶性程度高,侵犯附近组织器官及血行转移,易误诊;早期患者经综合治疗后,生存期延长,晚期患者经综合治疗后预后仍然不佳。

Objective To investigate the clinical characteristics and effective treatment of olfactory neuroblastoma.Methods Clinical data from 12 cases of olfactory neuroblastoma were retrospectively analyzed.All patients were treated with tumor resection and radiotherapy（42-70 Gy）.Some patients received additional chemotherapy.Results Among the 12 patients,nasal congestion was present in 11（91.7%） and cervical lymph node or distant metastasis in 9（75.0%）.Five patients underwent 4-6 cycles of chemotherapy after surgery.After a median follow-up of 63 months（range 6-120 months）,1 patient（stage A） is alive and well now,1 patient（stage B）survived for more than 5 years,1 patient（stage C） survived for more than 5 years,and 1 patient（stage C） survived for 3 years.Conclusion Olfactory neuroblastoma,as a highly malignant tumor with violation of adjacent tissues and organs and hematogenous metastasis,is often misdiagnosed.Comprehensive treatment can prolong survival in patients with early olfactory neuroblastoma,but patients with advanced olfactory neuroblastoma still have poor prognosis.