摘要
目的 总结分析头颈部多原发癌（multiple primary carcinoma,MPC）的临床特点.方法 回顾性分析2008年1月-2015年11月解放军总医院耳鼻咽喉头颈外科的71例MPC患者,包括20例同时性MPC患者,51例异时性MPC患者.其中63.4％ （45/71）为头颈部区域癌化（field cancerization of head neck,FCHN）,36.6％ （26/71）为头颈部非区域癌化（non-field-cancerization of head neck,NFCHN）.对间隔时间为0的同时性MPC患者,FCHN患者选择放化疗综合治疗,NFCHN患者首先治疗病变较重的部位;对其他类型的MPC患者,根据国际指南或国内专家共识,治疗首发部位及后续发生部位的肿瘤.结果 平均随访63.4个月,3年和5年总生存率（overall survival,OS）分别为84.6％和75.7％;其中同时性MPC的3年和5年OS分别为56.4％和37.6％,异时性MPC的3年和5年OS分别为92.2％和84.2％.两组间比较,异时性MPC的OS明显高于同时性MPC（P=0.0001）;FCHN患者3年和5年OS分别为85.7％和77.9％,NFCHN患者3年和5年OS分别为82.9％和72.8％.两组间比较差异无统计学意义（P=0.62）.结论 通过正确的诊断和有效的根治性治疗,部分MPC患者得到长期存活,其中异时性MPC患者得到更好的预后.
Objective To analyze the clinical characteristics of multiple primary cancers （MPC）associated with head and neck.Methods A total of 71 patients with MPC associated with head and neck treated from January 2008 to November 2015 were included in the retrospective study,of them 20 patients were synchronous MPC and 51 patients were metachronous MPC;45 （63.4%） patients were field cancerization of head neck （FCHN） and 26 （36.6%） patients were non-field cancerization of head neck （NFCHN）.For the synchronous MPC patients with an interval of 0 month,the lesion sites of FCHN were treated with combined chemotherapy and radiotherapy,the site of severe lesion of NFCHN received firstly a standard treatment.Other types of MPC were treated according to international guide lines or experts consensus.Results With the mean follow-up of 63.4 months,the 3-year and 5-year overall survival （OS）were 84.6% and 75.7% respectively.The 3-year and 5-year OS were 56.4% and 37.6% respectively in patients with synchronous MPC,and were 92.2% and 84.2% respectively in patients with metachronous MPC.There was significant difference in the OS between patients with metachronous MPC and patients with synchronous MPC （P =0.0002）.The 3-year and 5-year OS were 85.7% and 77.9% respectively in patients with FCHN,and were 82.9% and 72.8% respectively in patients with NFCHN,with no significant difference between the two groups （P =0.297）.Conclusion With correct diagnosis and effective curative treatment,some of patients with MPC can get long-term survival,showing the better prognosis in metachronous MPC compared to synchronous MPC.
出处
《中华耳鼻咽喉头颈外科杂志》
CAS
CSCD
北大核心
2016年第7期491-496,共6页
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
基金
国家自然科学基金，首都临床特色应用研究，吴阶平医学基金会临床科研专项资助基金(2013-428-2084)National Natural Science Foundation of China，Beijing Municipal Science and Technology Commission，Jieping Medical Special Foundation for clinical research
关键词
头颈部肿瘤
肿瘤
多原发性
综合疗法
预后
Head and neck neoplasms
Neoplasms,multiple primary
Combined modality therapy
Prognosis
