11例Kadish C期嗅神经母细胞瘤临床分析

Clinical observation on cases with olfactory neuroblastoma at Kadish stage C

目的探讨Kadish C期嗅神经母细胞瘤的治疗及预后。方法回顾性分析我科1993年1月～2003年12月收治的晚期嗅神经母细胞瘤患者的临床资料,总结治疗经验。结果11例患者中,男9例,女2例,平均年龄30．91岁；平均病程6．46月。1例因胸腰骶椎转移放弃治疗,其余10例均采用综合治疗,其中7例为手术+放疗,2例为手术+放疗+化疗,1例为手术+化疗。手术方式包括鼻侧切开3例,颅面切除2例,颅鼻内镜联合2例,冠状开颅2例,鼻内镜1例。全组病例中5例复发,复发时间平均33．4月。结论Kadish C期嗅神经母细胞瘤复发率高,随访时间应长,首次治疗宜采取综合治疗,挽救治疗有效。

Objective To explore the therapeutic procedures for olfactory neuroblastoma at Kadish stage C and the prognosis of cases with this lesion. Methods A retrospective study was carried out among 11 cases with this lesion, treated in our Hospital from Jan, 1993 to Dec, 2003, to sum up the clinical experience with diagnosis and treatment of the condition. Results Among the 11 cases treat- ed here, there were 9 males and 2 females, with an averaged age at 30.91 years old and averaged ill course of 6.46 months. Except one case gave up any therapies because of metastases to thoracic, lum- bar and sacral vertebrae, other 10 cases were treated by a combined therapy, with 7 treated by surgery plus radiotherapy, 2 by surgery plus radiation and chemotherapy, and 1 by surgery plus chemotherapy. The operation included lateral rhinotomy for 3 cases, tumor removing via cephalofacial approach for 2 cases, cephalonasal approach under endoscope for 2 cases, craniotomy via coronary approach for 2 cases and endoscopy for 1 case. Five were reoccurred with the lesion among this group of cases, with an av- eraged reoccurring period of 33.4 months. Conclusion Olfactory neuroblastoma at Kadish stage C holds very high rate of reoccurring. Cases with this lesion should be treated by a combined therapy at first and be followed up for a longer period following treatment. Once it reoccurred, remedy treatment may be beneficial for such cases.