背景:颞下窝(ITF)肿瘤表现为多种病理,在文献中很少描述,反映他们的稀有性。在这里,我们回顾了有关肿瘤侵袭ITF的文献,并描述了患者的特征,治疗策略,和临床结果。
方法:相关文章来自PubMed,Scopus,还有Cochrane.对其临床表现进行了系统评价和荟萃分析,治疗方案,和临床结果。
结果:共27篇,包含106例ITF肿瘤患者(中位肿瘤大小:24.3cm3[四分位距,15.2-42cm3])包括在内(中位年龄:46岁[四分位数范围,32-55岁];59.4%为男性])。在确诊的肿瘤病理数据中,神经鞘瘤(n=24;26.1%)和脑膜瘤(n=13;14.1%)是最常见的肿瘤。面部感觉减退(n=22;18.5%),耳廓/耳前疼痛(n=20;16.8%),头痛(n=11;9.2%)是最常见的症状。在接受手术切除的患者中(n=97;95.1%),70例(73.7%)接受了经颅手术(TCS),25例(26.3%)接受了鼻内镜手术(EES)。在有关切除程度的可用详细信息中(n=84),总切除(GTR)62例(73.8%),5例(6.0%)仅活检。35例(33.0%)患者发生术后并发症。在有重建技术可用数据的病例中(n=8),四个(50%)有脂肪筋膜前外侧大腿皮瓣,三个(37.5%)有背阔肌游离皮瓣,1例(12.5%)有大腿前外侧皮瓣。14例(13.2%)患者接受了辅助化疗,16例(15.1%)接受辅助放疗。在28个月的中位随访时间(IQR,12.25-45.75个月),15例(14.2%)患者复发,18例(17.0%)患者死亡。中位总生存期(OS)为36个月(95%可信区间:29-41个月),5年无进展生存率(PFS)为61%。
结论:具有不同生物学特性的多种肿瘤类型侵入ITF。本研究描述了患者的人口统计学,临床表现,管理,和结果。根据肿瘤类型和患者情况,建议对患者进行量身定制的管理,以优化治疗结果.
BACKGROUND: Infratemporal fossa (ITF) tumors represent various pathologies and are seldom described in the literature, reflecting their rarity. Here we
review the literature on tumors invading ITF and describe patient characteristics, treatment strategies, and clinical outcomes.
METHODS: Relevant articles were retrieved from PubMed, Scopus, and Cochrane. A systematic
review and meta-analysis were conducted on the clinical presentation, treatment protocols, and clinical outcomes.
RESULTS: A total of 27 articles containing 106 patients with ITF tumors (median tumor size: 24.3 cm3 [interquartile range, 15.2-42 cm3]) were included (median age: 46 years [interquartile range, 32-55 years]; 59.4% were males]). Of the confirmed tumor pathology data, schwannomas (n = 24; 26.1%) and meningiomas (n = 13; 14.1%) were the most common tumors. Facial hypoesthesia (n = 22; 18.5%), auricular/preauricular pain (n = 20; 16.8%), and headaches (n = 11; 9.2%) were the most common presenting symptoms. Of patients who had surgical resection (n = 97; 95.1%), 70 (73.7%) had transcranial surgery (TCS) and 25 (26.3%) had endoscopic endonasal surgery (EES). Among available details on the extent of resection (n = 84), gross-total resection (GTR) was achieved in 62 (73.8%), and 5 (6.0%) had biopsy only. Thirty-five (33.0%) patients had postoperative complications. Among cases with available data on reconstruction techniques (n = 8), four (50%) had adipofascial antero-lateral thigh flap, three (37.5%) had latissimus dorsi free flap, and one (12.5%) had antero-lateral thigh flap. Fourteen (13.2%) patients had adjuvant chemotherapy, and sixteen (15.1%) had adjuvant radiotherapy. During a median follow-up time of 28 months (IQR, 12.25-45.75 months), 15 (14.2%) patients had recurrences, and 18 (17.0%) patients died. The median overall survival (OS) time was 36 months (95% confidence interval: 29-41 months), and the 5-year progression-free survival (PFS) rate was 61%.
CONCLUSIONS: Various tumor types with different biological characteristics invade the ITF. The present study describes patient demographics, clinical presentation, management, and outcomes. Depending on the tumor type and patient condition, patient-tailored management is recommended to optimize treatment outcomes.