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目的:观察序贯性综合治疗方案治疗43例上颌窦癌患者的临床疗效及生存质量。方法:对43例上颌窦癌患者采用颞浅动脉插管诱导化疗加手术加根治性放疗的序贯性综合治疗方案,另有18例患者在综合治疗方案结束后再加巩固性化疗,随访5年,统计3年生存率、5年生存率及生存质量。结果:所有患者均可耐受此治疗方案,经过5年随访,失访5例,随访率达88.4%。全组患者5年生存率为46.5%(20/43),3年生存率为65.1%(28/43)。无一例施行眶内容物摘除术,12例患者恢复工作和劳动能力。结论:颞浅动脉插管诱导化疗加手术加根治性放疗治疗上颌窦癌是提高远期疗效的有效方案。其中颞浅动脉插管诱导化疗具有局部药物浓度高、单周期化疗原发灶肿瘤退缩明显、不拖延手术时机等优点;联合手术及术后根治性放疗可提高局控率。而术后巩固性化疗可进一步减少远处转移的风险。
Objective: To observe the clinical efficacy and quality of life of 43 patients with maxillary sinus cancer treated by sequential comprehensive treatment. Methods: Forty-three patients with maxillary sinus cancer underwent sequential combined therapy of induction of chemotherapy with superficial temporal artery and radical resection combined with radical radiotherapy. In addition, 18 patients were treated with consolidation chemotherapy after the completion of the comprehensive treatment program, followed up for 5 Years, statistics 3-year survival rate, 5-year survival rate and quality of life. Results: All patients were able to tolerate this treatment. After 5 years of follow-up, 5 patients were lost and the follow-up rate was 88.4%. The 5-year survival rate was 46.5% (20/43) in all patients and 65.1% (28/43) in 3-year survival rate. None of the cases performed orbital exen- sion, and 12 patients recovered their work and ability to work. Conclusion: The treatment of maxillary sinus cancer with superficial temporal artery catheterization chemotherapy and radical operation with radical radiotherapy is an effective way to improve the long-term curative effect. Among them, the induction of superficial temporal artery catheterization chemotherapy has the advantages of high local drug concentration, obvious tumor regression in the primary chemotherapy of single-cycle chemotherapy and no delay in the timing of the operation. Combined surgery and postoperative radical radiotherapy can improve the rate of local control. Postoperative consolidation chemotherapy can further reduce the risk of distant metastases.