背景:上颌窦鳞状细胞癌(MSSCC)是一种相对罕见的头颈部癌,预后不明确,本研究旨在探讨不同治疗方法对MSSCC的治疗效果。
方法:回顾性分析2007-2017年天津医科大学肿瘤医院病理数据库,收集98例经病理证实的MSSCC患者。对每位患者进行回顾性分析和随访。采用Cox回归模型对预后因素进行多因素分析。
结果:对于所有98例MSSCC,5年总生存率(OS)和无病生存率(DFS)分别为31.0%和29.3%,分别。在98名患者中,33例患者接受了全身治疗(NON-SUR),19例患者接受新辅助化疗和/或放疗,然后手术(CT/RT+SUR),38例患者接受手术,然后化疗和/或放疗(SUR+RT/CT),8例患者单独进行手术(SUR)。各组OS率为27.3%,57.9%,30.6%和37.5%,分别,而DFS为21.2%,36.8%,31.6%和25.0%,分别。CT/RT+SUR组的OS率明显高于NON-SUR组和SUR+CT/RT组(P<0.05)。多变量分析表明,吸烟,低分化,晚期T分期是OS的独立危险因素,而DFS的低分化和晚期N期。
结论:基于手术的治疗仍然是MSSCC的一线治疗策略。对于MSSCC患者,强烈推荐新辅助放化疗后再手术,尤其是那些患有晚期肿瘤或要求高质量生活的患者。
BACKGROUND: Maxillary sinus squamous cell carcinoma (MSSCC) is a relatively rare head and neck cancer with poorly defined prognosis, and the present study aimed to investigate the outcomes for MSSCC according to different treatments.
METHODS: Tianjin Medical University Cancer Institute and Hospital pathology database was reviewed from 2007 to 2017, and 98 patients with pathologically confirmed MSSCC were enrolled. Retrospective analysis and follow-up were performed for each patient. Multivariate analysis of prognostic factors was performed using Cox\'s regression model.
RESULTS: For all the 98 cases of MSSCC, the 5-year overall survival (OS) and disease-free survival (DFS) rates were 31.0% and 29.3%, respectively. Among 98 patient, 33 patients were treated with systemic treatment (NON-SUR), 19 patients underwent neoadjuvant chemotherapy and/or radiotherapy followed by surgery (CT/RT+SUR), 38 patients received surgery followed by chemotherapy and/or radiotherapy (SUR+RT/CT), and 8 patients were performed surgery alone (SUR).The OS rate for each group was 27.3%, 57.9%, 30.6% and 37.5%, respectively, while the DFS was 21.2%, 36.8%, 31.6% and 25.0%, respectively. The OS rate of CT/RT+SUR was significantly higher than that of NON-SUR and SUR+CT/RT groups (P < 0.05). Multivariate analysis revealed that smoking, low differentiation, and advanced T stage were independent risk factors for OS, while low differentiation and advanced N stage for DFS.
CONCLUSIONS: Surgery-based treatment is still the first-line therapeutic strategy for MSSCC. And neoadjuvant chemoradiotherapy followed by surgery is highly recommended for MSSCC patients, especially those with advanced tumors or requesting high quality of life.