Abstract：Objective To investigate the prognosis and influencing factors of different treatment strategies in T3-T4 nasal sinus adenocarcinoma. Methods The data of 93 cases of T3-T4 stage nasal sinus adenocarcinoma diagnosed from 2006 to 2018 were retrospectively analyzed. All patients were divided into combined operation group and non-operation group. The survival status and failure mode after corresponding treatment were analyzed. The enumeration data were analyzed by Chi-square test or Fisher's exact test. Survival analysis was performed by Kaplan-Meier method. Univariate analysis was conducted by log-rank test. Multivariate prognostic analysis was performed by Cox model. Results The average follow-up time in the whole cohort was 81.3 months (18-156 months). By the end of follow-up, a total of 38.7% (36/93) of patients had local recurrence, 14.0% (13/93) had distant metastasis, 17.2% (16/93) had local recurrence complicated with distant metastasis, and 28.0% (26/93) were stable. The overall 2-, 5-, and 10-year overall survival (OS) and progression free survival (PFS) rates were 83.5%, 59.3%, 31.8% and 73.6%, 40.7% and 25.3%, respectively. In univariate analysis, the PFS and OS of patients aged 46-64 years old (all P<0.001), male (P=0.022, P=0.001), patients with lesions located in the maxillary sinus (P=0.001, P<0.001), adenoid cystic carcinoma (P=0.001, P<0.001), non-invasion of orbital / clivus (P=0.041, P<0.001), GTVP dose>64 Gy (P=0.003, P=0.006) and N1 stage (P=0.014, P=0.014) were statistically different among different treatment modes. Multivariate analysis showed that age ≥65 years old (P=0.012, P=0.005), orbital / clival invasion (P<0.001, P=0.005), and GTVp dose ≤64 Gy (P<0.001, P=0.011) were the independent adverse prognostic factors affecting PFS and OS in T3-T4 stage nasal sinus adenocarcinoma. Conclusions The local failure rate of T3-T4 stage nasal sinus adenocarcinoma is high after treatment. Age, orbital / clival invasion, and GTVp dosage are the independent adverse prognostic factors. Surgery based intervention is superior to other treatment strategies.
Lu Xiaoxu,Sun Xueming,Huang Rong et al. Long-term prognostic analysis of different treatment strategies for T3-T4 nasal sinus adenocarcinoma[J]. Chinese Journal of Radiation Oncology, 2023, 32(4): 287-292.
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