上颌窦癌的治疗与预后因素分析

Analysis of Treatment and Prognostic Factors of Maxillary Sinus Carcinoma

目的探讨上颌窦癌的临床特点、治疗方法及预后。方法回顾性分析1988年5月至1998年5月收治的72例上颌窦癌临床资料,男51例,女21例,中位年龄51岁。治疗方式:手术+放射治疗40例(55.5%),单纯放射治疗20例(27.8%),单纯手术12例(16.7%)。结果5年总生存率为40.3%(29/72),手术+放射治疗组为47.5%,明显高于单纯放射治疗组(20.0%,P<0.05)。Ⅰ、Ⅱ期5年生存率63.6%(14/22),Ⅲ、Ⅳ期5年生存率30.0%(15/50)(P<0.05)。腺癌的5年生存率明显低于鳞癌。结论上颌窦癌的治疗以综合治疗为主,病理类型、临床分期和临床治疗方法对预后有重要影响。

Objective To define the clinical characteristics, treatment method and prognosis of maxillary sinus carcinoma. Methods From May 1988 to May 1998,72 such patients were analyzed retrospectively as maxillary sinus carcinoma, including 51 males and 21 females with a median of 51 years. 40（55.6%） patients received preoperative radiotherapy followed by surgery, 20 （27.8%） patients radiotherapy alone an 12（16.7%） surgery alone. Results The overall 5-year survival rate was 40.3% （29/72）. The 5-year survival rate of combined treatment was significantly higher than that of radiotherapy alone （47.5% vs 20.0%, P 〈 0.05）. The 5-year survival rate was 63.6% in patients with Stage Ⅰ～Ⅱ maxillary sinus carcinoma, while they were only 30.0% in Staye Ⅲ～Ⅳ lesions（P 〈 0.05）. Patients with adenocarcinoma had obviously poorer 5-year survival survival rate than patients with squamous cell carcinoma （P 〈 0.05）. Conclusion We recommend combined therapy for maxillary sinus carcinoma. And clinical stage, treatment approach and histological type are identified as maxillary sinus carcinoma predictors.