30例嗅神经母细胞瘤的临床分析

Clinical analysis on 30 cases of esthesioneuroblastoma

目的探讨嗅神经母细胞瘤的临床特征、治疗方法与预后的关系。方法回顾性分析1992年1月至2007年5月间我院收治的30例嗅神经母细胞瘤患者的临床资料。采用Kaplan-Meier法分析全组临床分期、颈部淋巴结转移情况、治疗方式、眼眶内颅内侵犯情况和年龄与预后的关系。结果本组患者总5年生存率为43.3%。临床分期A+B期、C期5年生存率分别为80%、25%,两组患者生存率比较差异有统计学意义(P<0.05);颈部淋巴结转移阳性组与阴性组的5年生存率分别为25%、55.6%,两组生存率比较差异有统计学意义(P<0.05);单纯手术组、单纯放疗组、单纯化疗组、手术联合放化疗组、放疗联合化疗组患者的5年生存率分别为0%、33.3%、33.3%、52.9%、33.3%(P>0.05);有眼眶内颅内侵犯与无眼眶内颅内侵犯的患者5年生存率分别为21.4%、62.5%,两组生存率差异有统计学意义(P<0.05);发病年龄≥50岁与发病年龄<50岁的患者5年生存率分别为23.1%、58.8%,两组生存率差异有统计学意义(P<0.05)。结论嗅神经母细胞瘤预后与年龄、临床分期、有无颈部淋巴结转移以及眼眶内颅内侵犯有关。

Objective To Study the correlation between prognostic factors and clinical features as well as treatment approaches of esthesioneuroblastoma （ENB）. Methods Clinical data of 30 ENB patients treated at our hospital from Jan 1992 to May 2007 were analyzed retrospectively. The correlation between prognostic factors and clinical features as well as treatment approaches was analyzed by Kaplan-Meier method. Results The 5-year overall survival （OS） of the whole group was 43.3%. The 5-year OS of the subgroups of Kadish stage A ＋ B and stage C were 80% and 25% respectively,the difference between the two subgroups was statistically significant （ P 〈 0. 05 ）. The 5-year OS of the subgroups with and without cervical lymph node metastasis were 25% and 55.6% respectively, which was statistically significant （ P 〈 0.05 ）. The 5-year OS of the subgroups treated by surgery, radiotherapy, chemotherapy, surgery combined with chemoradiotherapy and chemoradiotherapy only were 0,33.3 % , 33. 3 % , 52. 9% and 33.3% , respectively, the differences among these subgroups were not statistically significant. The 5-year OS of the subgroups with and without intracalvarium invasion were 21.4% and 62.5% respectively, which was statistically significant （P 〈 0. 05）. The 5-year OS of the subgroups of age ≥50 and 〈50 were 23.1% and 58. 8% respectively,which was statistically significant （ P 〈 0. 05 ）. Conclusions Prognosis of ENB is associated with patient＇ s age, clinical stage, cervical lymph nodal metastasis and intracalvarium invasion.