中国口腔颌面外科杂志

中国口腔颌面外科杂志 ›› 2022, Vol. 20 ›› Issue (2): 146-150.doi: 10.19438/j.cjoms.2022.02.008

• 论著 • 上一篇    下一篇

101例头颈部横纹肌肉瘤临床、病理及预后分析

陈一铭, Ahmed, 季彤*, 任振虎*   

  1. 上海交通大学医学院附属第九人民医院 口腔颌面-头颈肿瘤科,上海交通大学口腔医学院,国家口腔医学中心,国家口腔疾病临床研究中心,上海市口腔医学重点实验室,上海 200011
  • 收稿日期:2021-10-06 修回日期:2022-01-19 出版日期:2022-03-20 发布日期:2022-03-20
  • 通讯作者: 任振虎,E-mail：zhenhuren@126.com;季彤,E-mail：jitongjitong@foxmail.com。*共同通信作者
  • 作者简介:陈一铭（1989-）,男,博士,主治医师,E-mail：781368531@qq.com
  • 基金资助:
    上海市市级医院新兴前沿技术联合攻关项目(SHDC22017101)

Rhabdomysarcoma of head, neck: clinical, pathological, prognosis analysis of101consecutive cases

CHEN Yi-ming, Ahemd, JI Tong, REN Zhen-hu   

  1. Department of Oromaxillofacial Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Disease; Shanghai Key Laboratory of Stomatology. Shanghai 200011, China
  • Received:2021-10-06 Revised:2022-01-19 Online:2022-03-20 Published:2022-03-20

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摘要： 目的:总结头颈部横纹肌肉瘤的临床病理特点及影响预后的因素。方法:对上海交通大学医学院附属第九人民医院2006—2013年收治的头颈部横纹肌肉瘤患者进行回顾性研究。收集患者的临床、影像、病理、治疗资料及随访记录,采用SPSS 22.0软件包对数据进行统计分析。结果:给定时间段内共纳入101例患者,75例获得随访。其中,男52例,女49例;18岁以下50例,18岁以上51例。口腔黏膜、腮腺和颅底是最常见的发病部位;多形型65例,胚胎型27例,腺泡型9例;IRS Ⅰ级44例,Ⅱ级39例,Ⅲ级18例。29例仅接受手术治疗,20例同时接受手术和化疗,10例接受手术和放疗,42例接受上述3种治疗。8例病理结果提示颈淋巴结阳性,无手术阳性切缘。5年无瘤生存率为41.3%,5年总体生存率为44.0%。结论:头颈部横纹肌肉瘤5年总体生存率和无瘤生存率较低,IRS分级和肿瘤部位是影响生存的主要因素。切缘阴性的根治性手术治疗对头颈部横纹肌肉瘤预后至关重要;放疗、化疗等辅助治疗可提高肿瘤局部控制率及总体生存率。

关键词: 头颈部, 横纹肌肉瘤, 治疗, 预后

Abstract: PURPOSE: To analyze the clinical and pathological features as well as the prognostic factors for head and neck rhabdomyosarcoma(RMS). METHODS: A retrospective study of patients with head and neck RMS treated in Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from 2006 to 2013 was conducted. The clinical, radiological, pathological, treatment information and follow-up records were collected. Statistical analysis was performed with SPSS 22.0 software package. RESULTS: A total of 101 patients were treated in the given time period, among them 75 were followed-up: 52 were male and 49 were female; 50 were younger than 18 years old, 51 were above 18 years old. Buccal mucosa, parotid region and skull base were the most common sites of the disease. Sixty-five cases were pleomorphic type, 27 were embryonal type and 9 were acinar type. Forty-four patients with IRS gradeⅠ, 39 with grade Ⅱ and 18 with grade Ⅲ. Twenty-nine subjects underwent surgery only, 20 subjects were managed simultaneously with both surgery and chemotherapy, 10 underwent surgery and radiotherapy, 42 were managed by tri-modality. Eight had positive cervical lymph node in final pathological results, no positive surgical margin was found. The 5-year disease free survival(DFS) was 41.3%, while the 5-year overall survival(OS) was 44.0%. CONCLUSIONS: Head and neck rhabdomyosarcoma has a poor 5-year OS and DFS, with IRS grades and tumor sites as the main independent prognostic factors for survival. Radical surgical treatment with negative margins is critical for RMS, and adjuvant therapies such as radiotherapy and chemotherapy may improve local control rate and survival rate of the patients.

Key words: Head and neck, Rhabdomyosarcoma, Treatment, Prognosis

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