Kadish C期嗅神经母细胞瘤的综合治疗

Comprehensive treatment for Kadish stage C esthesioneuroblastoma

目的探讨KadishC期嗅神经母细胞瘤合理的治疗方法。方法回顾性分析6例KadishC期嗅神经母细胞瘤的临床资料。均采取以手术为主，结合放疗、化疗或同步放化疗等措施的综合治疗。其中3例为初治病例，3例为复发病例。6例术中送冰冻病理，切缘均阴性。结果5例整块全切除的患者随访20个月以上，无复发；1例分块全切除的患者，术后11个月死于肿瘤复发。并发症包括3例气颅，2例精神症状，1例脑脊液鼻漏。结论KadishC期嗅神经母细胞瘤治疗宜选择以手术为主的多学科综合治疗。手术可采用经额下入路，无瘤原则和颅底重建非常重要。

Objective To investigate the treatment for Kadish stage C Method The medical recorders of six patients with Kadish stage C esthesioneuroblastoma were analyzed retrospectively. All were nminly treated with surgeries, combined with radiation therapy, chemotherapy, or chemoradiation. 3 of 6 patients were first admitted, whereas the others were recurrence. Result Five patients with enbloc resection were followed up for more than 20 months with no tumor recurrence occurred. The patient performed piecemeal resection died of the recurrence in the llst month after surgery. Complications included pneumocephalus in 3 cases, mental disturbance in 2, and CSF leakage in 1. Conclusion Kadish stage C treatment needs surgical dominant multi -discipline treating pattern. Surgery can be performed via subfrontal approach. Tumor-free principle and skull base reconstruction are of great importance.