头颈部韧带样瘤的治疗

Treatment of desmoid tumour in head and neck

目的探讨头颈部韧带样瘤手术及放疗等治疗方法的效果。方法回顾性分析复旦大学肿瘤医院头颈外科1987--2002年期间收治的44例头颈部韧带样瘤患者的临床资料和随访情况，评估外科治疗和放疗的疗效。结果根据患者病情分为3组：单纯手术组15例，均为术后病理检查显微镜下证实切缘均为阴性者，随访12—156个月，局部复发率26．7％（4／15）。手术＋术后补充放疗12例，均为术后肿瘤残留患者，其中显微镜下病理检查切缘阳性5例，肉眼可见肿瘤残留7例，随访时间16—164个月，均无复发；外院手术后复发再放疗组17例，放疗后肿瘤残留率23．5％（4／17），随访时间15—136个月，局部复发率17．6％（3／17）。所有患者未发现远处转移，也没有与此病相关的死亡。结论对于头颈部韧带样瘤，外科手术难以切除彻底，应尽可能地保留患者的外形与功能，提高患者的生存质量。术后须补充放疗，能取得满意疗效。对于初次手术复发的患者，再行放疗，也能获得较佳预后。

Objective To find out the suitable therapy for the patient of desmoid tumour in head and neck. Methods Forty-four patients with desmoid tumours of the head and neck treated at Cancer Hospital of Fudan University between 1987 and 2002 were identified from inpatient tumour database. Patients were classified into three groups： operation group （ 15 cases） ; operation ＋ radiation group （12 cases） ; radiation group （17 cases）. All patients were prospectively followed. Clinicopathologic features and treatment modalities were evaluated. Results In the group of operation, four of operation group had recurrences 26. 7% （4/15）. In the group of radiation, three of radiation group had recurrences 17.6% （3/17）. And the recurrence of operation ＋ tradiation group was 23.5% （4/17）. No patient died of their disease. ConcIusion For desmoid tumors of the head neck, operation ＋ radiation was recommended, and the benefits of radiation therapy were demonstrated.