58例炎性肌纤维母细胞瘤临床特点与疗效分析

Clinical features and treatment outcome of inflammatory myofibroblastic tumor：a retrospective study of 58 patients

目的 分析炎性肌纤维母细胞瘤患者局部区域复发风险和影响长期生存的相关因素。方法 回顾分析2002—2017年本院收治的58例首程治疗或首程辅助治疗的炎性肌纤维母细胞瘤患者资料。采用Kaplan-Meier法计算生存率,Logrank法检验和单因素预后分析。结果 中位随访34个月,单纯手术50例,手术＋辅助放疗7例。17例治疗失败,16例为LRR,3例DM中2例合并局部失败。5例死因为肿瘤复发或转移。5年LRRFS率为75%、OS率为90%。单因素分析提示手术切缘（P=0.018）及肿瘤局部分期（P=0）是影响LRRFS因素。结论 外科根治性切除联合辅助治疗是提高炎性肌纤维母细胞瘤疗效的关键。

Objective To evaluate the risk of locoregional recurrence （LRR） and the influencing factors for long-term survival in patients with inflammatory myofibroblastic tumor （IMT）. Methods A retrospective analysis was performed for 58 IMT patients who completed initial therapy or initial adjuvant therapy in our hospital from January 2002 to January 2017 to evaluate their failure patterns and survival. The LRR and survival rates were compared between groups. The Kaplan-Meier method was used to calculate survival rates,and the log-rank test was used for survival difference analysis and univariate prognostic analysis. Results The median follow-up time was 34 months. Among the 58 patients,50 underwent surgery alone,and 8 underwent surgery and adjuvant therapy. Seventeen patients experienced treatment failure,16 patients developed LRR,3 patients developed distant metastasis,including 2 patients with local failure,and 5 patients died of tumor recurrence or metastasis. The 5-year LRRFS was 75%,and the 5-year OS rate was 90%.The univariate analysis showed that resection margin and local staging were influencing factors for LRRFS （P=0.018,0）. Conclusions Radical resection combined with adjuvant therapy is the key to improving the treatment outcome of IMT.