31例头颈部骨外浆细胞瘤患者临床特点及预后分析

doi:10.3760/cma.j.cn113030-20220118-00024

摘要
图/表
参考文献(24)
相关文章 (15)
点击分布统计
下载分布统计

全文: PDF (0 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS) 背景资料

摘要目的探讨头颈部骨外浆细胞瘤（EMP）的临床特点、治疗情况及预后相关因素。方法回顾性分析复旦大学附属眼耳鼻喉科医院2005年1月至2020年1月收治的31例头颈部EMP患者的临床资料。按病灶累及部位,分为未累及韦氏环组和累及韦氏环组。采用单因素卡方检验分析组间差异,采用Kaplan-Meier法分析总生存（OS）期。组间OS率和无局部复发生存（LRFS）率比较用log-rank检验。结果 31例患者全部接受了放射治疗,中位随访时间98（7~192）个月。其中16例患者同时接受了手术,10例患者同时接受了化疗,2例患者同时接受了手术和化疗。15例患者累及韦氏环,16例患者未累及韦氏环。10年OS率84.8%,2例发生了局部复发,2例发展为多发性骨髓瘤。年龄≤55岁和>55岁者10年OS率为100%∶67.0%（P=0.039）;累及韦氏环者和未累及者10年OS率为93.3%∶75.2%（P=0.031）,二者10年LRFS率为100%∶66.7%（P=0.022）。放疗前肿瘤最长径≤5 cm者10年总生存率达95.0%,>5 cm者为35.7%（P=0.020）。结论头颈部EMP患者放疗前肿瘤最长径≤5 cm者有更好的10年OS率,累及韦氏环者有更好的10年OS率和LRFS率。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	王天
	田姝
	丁浩

关键词 ：骨外浆细胞瘤,头颈部, 临床特点, 放疗剂量, 韦氏环累及, 预后

Abstract：Objective To investigate the clinical features, treatment options and prognostic factors of extramedullary plasmacytoma of the head and neck. Methods Clinical data of 31 cases of extramedullary plasmacytoma of the head and neck treated in Eye Ear Nose and Throat Hospital of Fudan University from January 2005 to January 2020 were retrospectively analyzed. According to the involvement sites, the lesions were divided into the Waldeyer's ring involvement and non-involvement groups. The differences between two groups were compared by one-way ANOVA. The overall survival (OS) was analyzed by Kaplan-Meier method. The OS rate and local recurrence free survival (LRFS) rate between two groups were compared by log-rank test. Results All 31 patients received radiotherapy. The median follow-up time was 98 months (7-192 months). Among them, 16 patients received radiotherapy and surgery, 10 patients received radiochemotherapy, and 2 patients received surgery and radiochemotherapy. Waldeyer's ring involvement was found in 15 patients, and Waldeyer's ring was not involved in 16 patients. The 10-year OS rate was 84.8%. Two cases showed local recurrence and 2 cases progressed to multiple myeloma. The 10-year OS rate in patients ≤55 years old was 100% vs. 67% in those >55 years old (P=0.039). The 10-year OS rates in patients with and without Waldeyer's ring involvement were 93.3% vs. 75.2% (P=0.031). The 10-year LRFS rate in patients with Waldeyer's ring involvement was 100% vs. 66.7% in those without Waldeyer's ring involvement (P=0.022). The 10-year OS rate was 95% and 35.7% for patients with longest diameter of tumor ≤5 cm and >5 cm before radiotherapy, respectively (P=0.02). Conclusions Extramedullary plasmacytoma of the head and neck patients with longest diameter of tumor ≤5 cm obtain higher 10-year OS rate. Those with Waldeyer's ring involvement have better 10-year OS and LRFS rates.

Key words： Extramedullary plasmacytoma, head and neck Clinical feature Radiotherapy dose Waldeyer's ring involvement Prognosis

收稿日期: 2022-01-18

通讯作者: 丁浩,Email：eentding@163.com

引用本文:

王天,田姝,丁浩. 31例头颈部骨外浆细胞瘤患者临床特点及预后分析[J]. 中华放射肿瘤学杂志, 2023, 32(1): 1-7.

Wang Tian,Tian Shu,Ding Hao. Clinical features and prognosis analysis of 31 cases of extramedullary plasmacytoma of the head and neck[J]. Chinese Journal of Radiation Oncology, 2023, 32(1): 1-7.

链接本文:

http://journal12.magtechjournal.com/Jweb_fszlx/CN/10.3760/cma.j.cn113030-20220118-00024 或 http://journal12.magtechjournal.com/Jweb_fszlx/CN/Y2023/V32/I1/1

[1] Wen G, Wang W, Zhang Y, et al.Management of extramedullary plasmacytoma: role of radiotherapy and prognostic factor analysis in 55 patients[J]. Chin J Cancer Res, 2017,29(5):438-446. DOI: 10.21147/j.issn.1000-9604.2017.05.08.
[2] Finsinger P, Grammatico S, Chisini M, et al.Clinical features and prognostic factors in solitary plasmacytoma[J]. Br J Haematol, 2016,172(4):554-560. DOI: 10.1111/bjh.13870.
[3] Caers J, Paiva B, Zamagni E, et al.Diagnosis, treatment, and response assessment in solitary plasmacytoma: updated recommendations from a European expert panel[J]. J Hematol Oncol, 2018, 11(1):10. DOI: 10.1186/s13045-017-0549-1.
[4] Bachar G, Goldstein D, Brown D, et al.Solitary extramedullary plasmacytoma of the head and neck--long-term outcome analysis of 68 cases[J]. Head Neck, 2008,30(8):1012-1019. DOI: 10.1002/hed.20821.
[5] Alexiou C, Kau RJ, Dietzfelbinger H, et al.Extramedullary plasmacytoma: tumor occurrence and therapeutic concepts[J]. Cancer, 1999,85(11):2305-2314.
[6] Thumallapally N, Meshref A, Mousa M, et al.Solitary plasmacytoma: population-based analysis of survival trends and effect of various treatment modalities in the USA[J]. BMC Cancer, 2017,17(1):13. DOI: 10.1186/s12885-016-3015-5.
[7] Creach KM, Foote RL, Neben-Wittich MA, et al.Radiotherapy for extramedullary plasmacytoma of the head and neck[J]. Int J Radiat Oncol Biol Phys, 2009,73(3):789-794. DOI: 10.1016/j.ijrobp.2008.04.077.
[8] Padhi P, El-Behery R.Extramedullary solitary plasmacytoma with anaplastic features of the nasopharynx[J]. Case Rep Hematol, 2020,2020:8845546. DOI: 10.1155/2020/8845546.
[9] Hu X, Peng C, Wang P, et al. Extramedullary plasmacytoma of nasal cavity: a case report and literature review[J]. Ear Nose Throat J, 2020, 101(6):NP245-NP250. DOI: 10.1177/0145561320960005.
[10] Venkatesulu B, Mallick S, Giridhar P, et al.Pattern of care and impact of prognostic factors on the outcome of head and neck extramedullary plasmacytoma: a systematic review and individual patient data analysis of 315 cases[J]. Eur Arch Otorhinolaryngol, 2018,275(2):595-606. DOI: 10.1007/s00405-017-4817-z.
[11] Zhu Q, Zou X, You R, et al.Establishment of an innovative staging system for extramedullary plasmacytoma[J]. BMC Cancer, 2016, 16(1):777. DOI: 10.1186/s12885-016-2824-x.
[12] Pantazidou G, Papaioannou I, Karagkouni E, et al.Sinonasal extramedullary plasmacytoma with rare osteolytic lesions[J]. Cureus, 2021,13(3):e14220. DOI: 10.7759/cureus.14220.
[13] Skerget M, Dovsak T, Kos G, et al.Surgery results in low relapse and progression rates in extramedullary plasmacytoma of the head and neck: a case cohort and review of the literature[J]. Hematol Rep, 2020,12(2):8396. DOI: 10.4081/hr.2020.8396.
[14] Zhu X, Wang L, Zhu Y, et al.Extramedullary plasmacytoma: long-term clinical outcomes in a single-center in China and literature review[J]. Ear Nose Throat J, 2021,100(4):227-232. DOI: 10.1177/0145561320950587.
[15] Vlad D, Trombitas V, Albu S.Extramedullary plasmacytoma of the paranasal sinuses: combining surgery with external radiotherapy[J]. Indian J Otolaryngol Head Neck Surg, 2016,68(1):34-38. DOI: 10.1007/s12070-015-0826-7.
[16] Gerry D, Lentsch EJ.Epidemiologic evidence of superior outcomes for extramedullary plasmacytoma of the head and neck[J]. Otolaryngol Head Neck Surg, 2013,148(6):974-981. DOI: 10.1177/0194599813481334.
[17] Pham A, Mahindra A.Solitary plasmacytoma: a review of diagnosis and management[J]. Curr Hematol Malig Rep, 2019,14(2):63-69. DOI: 10.1007/s11899-019-00499-8.
[18] Kumar SK, Callander NS, Alsina M, et al.Multiple myeloma, version 3.2017, NCCN clinical practice guidelines in oncology[J]. J Natl Compr Canc Netw, 2017,15(2):230-269. DOI: 10.6004/jnccn.2017.0023.
[19] Suh YG, Suh CO, Kim JS, et al.Radiotherapy for solitary plasmacytoma of bone and soft tissue: outcomes and prognostic factors[J]. Ann Hematol, 2012,91(11):1785-1793. DOI: 10.1007/s00277-012-1510-6.
[20] Soutar R, Lucraft H, Jackson G, et al.Guidelines on the diagnosis and management of solitary plasmacytoma of bone and solitary extramedullary plasmacytoma[J]. Br J Haematol, 2004,124(6):717-726. DOI: 10.1111/j.1365-2141.2004.04834.x.
[21] Katodritou E, Terpos E, Symeonidis AS, et al.Clinical features, outcome, and prognostic factors for survival and evolution to multiple myeloma of solitary plasmacytomas: a report of the Greek myeloma study group in 97 patients[J]. Am J Hematol, 2014,89(8):803-808. DOI: 10.1002/ajh.23745.
[22] Mendenhall WM, Mendenhall CM, Mendenhall NP.Solitary plasmacytoma of bone and soft tissues[J]. Am J Otolaryngol, 2003,24(6):395-399. DOI: 10.1016/s0196-0709(03)00092-9.
[23] Tsang RW, Gospodarowicz MK, Pintilie M, et al.Solitary plasmacytoma treated with radiotherapy: impact of tumor size on outcome[J]. Int J Radiat Oncol Biol Phys, 2001,50(1):113-120. DOI: 10.1016/s0360-3016(00)01572-8.
[24] Tournier-Rangeard L, Lapeyre M, Graff-Caillaud P, et al.Radiotherapy for solitary extramedullary plasmacytoma in the head-and-neck region: a dose greater than 45 Gy to the target volume improves the local control[J]. Int J Radiat Oncol Biol Phys, 2006,64(4):1013-1017. DOI: 10.1016/j.ijrobp.2005.09.019.