Treatment Results and Prognostic Factors of Esthesioneuroblastoma (ENB)

嗅神經母細胞瘤治療成果與預後因子

王友明(Yu-Ming Wang) ； 王重榮(Chong-Jong Wang) ； 黃英彥(Eng-Yen Huang) ； 陳惠君(Hui-Chun Chen) ； 孫立民(Li-Min Sun) ； 方富民(Fu-Min Fang) ； 許軒之(Hsuan-Chih Hsu) ； 熊敬業(Ching-Yeh Hsiung) ； 黃郁傑(Yu-Jie Huang) ； 汪昶佑(Chang-Yu Wang)

《放射治療與腫瘤學》 12卷3期 (2005/09) Pp. 191-198

https://doi.org/10.6316/TRO/200512(3)191

摘要

目的：探討有關於嗅神經母細胞瘤之治療成果與預後因子。
材料與方法：自1989年至2004年共有21位診斷為嗅神經母細胞瘤的病患於本科治療，包括14位男性與7位女性。病患年齡分布自17歲至88歲。我們分析了病患之初期症狀、腫瘤大小、治療方式、與存活時間。10位病患(48%)接受了傳統定位方式的放射治療，11位病患(52%)接受了立體定位順形放射治療。病患之生活活動程度評估依照Karnofsky Performance Scale (KPS)紀錄。腫瘤之分期依據Kadish分期。
結果：在分析的21位病患中2位病患為A期，3位為B期，16位為C期。在35個月的平均追蹤時間後，有4位病患存活，另4位存活但有腫瘤。6位病患發生局部復發，另有5位病患產生遠端轉移。在15位發病初期沒有頸部淋巴腫大並沒有接受預防性頸部照射的病患中，3位(20%)發生了頸部復發。整體5年存活率為42%，5年無病存活率為17%。在單變數分析中發現，病患年齡與發病初期之KPS為影響存活率之預後因子。
結論：我們的研究成果與先前文獻中報告過的成果相近。我們發現病患年齡與KPS為影響存活之預後因子。由於頸部復發率在嗅神經母細胞瘤的病患中相對甚高，預防性的頸部照射似乎對病患有幫助。

關鍵字

知覺神經母細胞瘤 ； 嗅神經母細胞瘤 ； 放射治療

並列摘要

Purpose: To analyze treatment results and prognostic factors of esthesioneuroblastoma (ENB).
Materials and methods: Twenty-one patients with diagnosis of ENB treated between 1989 and 2004 were reviewed. There were 14 men and 7 women. Patients' age ranged from 17 to 88. Presenting symptoms/signs, tumor extent, treatment modalities, survival time, and disease-free survival time were recorded. Ten patients (48%) were treated with conventional two-dimensional technique and 11 (52%) with three-dimensional conformal radiotherapy (3D-CRT). Patient's performance status was scored with Karnofsky performance scale (KPS). Tumor extent was staged using Kadish system.
Results: Of the 21 patients, 2 were Stage A, 3 Stage B, and 16 Stage C. After a mean follow-up time of 35 months, 4 patients are alive with disease and 4 are alive without disease Locoregional failure occurred in 6 patients and distant metastases were noted in 5 patients. Of the 15 initially node-negative patients who did not receive elective neck irradiation, 3 (20%) failed in the neck. Five-year overall survival rate was 42% and 5-year disease free survival rate was 17%. In univariate analysis, age (≦60 vs. ＞60) and KPS (≧80 vs. ＜80) were significant prognostic factors for overall survival (p=0.019, p=0.000, respectively) and disease-free survival (p=0.021, p=0.001, respectively).
Conclusion: Treatment results in our series are compatible with others. We find that age and KPS are significant prognostic factors in predicting the outcome. Due to relatively high incidence of neck failure, elective neck irradiation seems worthy to be considered in selective patients.

並列關鍵字

Esthesioneuroblastoma ； Olfactory neuroblastoma ； Radiotherapy