鼻腔和鼻竇肉瘤

Sarcomas of the Nasal Cavity and Paranasal Sinuses

高仁傑(Jen-Chieh Kao) ； 許志宏(Chin-Hung Shu) ； 林清榮(Ching-Zong Lin)

《中華民國耳鼻喉科醫學會雜誌》 32卷4期 (1997/08) Pp. 399-403

https://doi.org/10.6286/1997.32.4.399

摘要

鼻腔和鼻竇的肉瘤(sarcoma)是比較罕見的疾病。本部提出過去24年來治療過的18個病例的經驗。其中17例施以手術合併術後放射線治療或化學治療。1名病人僅接受單獨的放射線治療。結果發現手術切除腫瘤後的邊緣狀況為重要的預後指標，切除邊緣沒有發現癌細胞的病人能獲得較佳的局部控制。所有橫紋肌肉瘤(rhabdomyosarcoma)和惡性纖維組織細胞瘤(malignant fibrohistiocytoma)的7個病例，都因局部復發感遠隔轉移而治療失敗，顯示某些高惡性等級的肉瘤雖然使用多種形式的治療，預後仍差。(中耳醫誌 1997;32:399-403)

關鍵字

鼻 ； 副鼻竇 ； 肉瘤

並列摘要

Sarcomas of the nose and paranasal sinuses are rare malignancies. Because of their rarity, diversity of type, and absence of uniform criteria of classification and staging, there is a lack of meaningful data regarding their clinical behavior, treatment, and prognosis. To help clarify these issuese, 18 cases of nasal and paranasal sinus sarcomas treated at our department between Jan. 1970 and June 1994 were retrospectively reviewed. One of the patients was managed with radiotherapy alone. The others were treated with surgery combined with post-operative radiotherapy. Some of them received chemotherapy. The patients with aggressive histologictypes such as rhabdomyosarcoma and malignant fibrohistiocytoma experienced the poorest outcome. High grade lesions place the patients at risk for local recurrence and distant dissemination. The 2-year and 5-year survival rates were 39% and 27%, respectively. The surgical margin status was found to be significantly related to the local control and outcome for sinonasal sarcomas. Patients with sinonasal sarcomas should undergo wide excision with the removal of all gross disease and the acquisition of negative, microscopic surgicalmargins. Patients with positive surgical margins should be treated with postoperative radiotherapy if reexcision is no possible.

並列關鍵字

nose ； paranasal sinus ； sarcoma