嗅神经母细胞瘤的化疗分析

Chemotherapy for Esthesioneuroblastoma

目的分析影响嗅神经母细胞瘤化疗的因素并探讨嗅神经母细胞瘤的化疗方案。方法回顾性地分析我科1993年3月，2004年6月收治的4例行化疗的嗅神经母细胞瘤病人的临床资料，包括就诊时年龄、性别、病程、Kadish分期、组织病理学分级、治疗方式，预后，并对文献进行回顾。结果男4例，平均年龄31．5岁，Kadish分期：均为C期。组织病理学分级：2级1例，3级2例，4级1例。化疗药物4例舍有足叶乙甙、3例含有铂类药物。化疗在首次治疗中应用1例（病理2级随访6月，带瘤生存），挽救治疗中应用3例（2例病理3级分别随访48月、6月无瘤生存，1例病理4级随访12月带瘤生存）。结论嗅神经母细胞瘤治疗采用化疗有效，组织病理学分级影响肿瘤对化疗敏感性．化疗宜采取含铂类厦足叶乙甙的多种药物。

Objective To analyse the impacting factors of chemotherapy for esthesioneuroblastoma and to discuss the suitable chemotherapy modality. Methods A retrospective analysis was given to the clinical data of 4 patients with treated with chemotheraph in our department from Mar. 1993 to Jun. 2004, including age, sex, course, Kadish Grading, Hymas Grading, modality and prognosis. Results 4 cases were male, the average age was 31.5 years old, all in Kadish C stage, 1 case was Hymns Grading Ⅱ,2 cases were Hymns Grading Ⅲ and 1 case Hymns Grading Ⅳ ;The main components of chemical drug were etoposide and platin; Chemotherapy were used as primary therapy on 1 case with Hymns Grading Ⅱ ,the patient was alive with tumor after followed-up for 6 months,and chemotherapy was used on 3 cases with salvage therapy （2 cases with Hymns Grading m were alive without tumor after followed-up for 48 months and 6 months, respectively ; one cases with Hymns Grading Ⅳ was alive with tumor after followed-up for 12 months）. Conclusions Chemotherapy is effective for asthesioneuroblastoma;Hymas Grading indicates the sensitivity of the tumor to chemotherapy ; The components of chemical drug should include etoposide and platin.