This study aimed to present the treatment patterns and outcomes for adenoid cystic carcinoma (ACC) arising in the nasal cavity and paranasal sinus. Sixty-one sinonasal ACC patients were retrospectively reviewed: 31 (50.8%) underwent surgery followed by postoperative radiation therapy (S+PORT), and 30 (49.2%) received definitive radiation therapy (D(C)RT). T4 disease was significantly more frequent in the D(C)RT group (25.8% vs. 80.0%,p< 0.001), where all T4b disease patients underwent D(C)RT. The 5-year local failure-free survival (LFFS), distant metastasis-free survival (DMFS), progression-free survival (PFS), and overall survival were 61.8% versus 37.8% (p= 0.003), 64.8% versus 38.1% (p= 0.036), 52.6% versus 19.3% (p= 0.010), and 93.2% versus 73.4% (p= 0.001) in the S+PORT and D(C)RT groups, respectively. The absolute differences in 5-year rates of LFFS, DMFS, and PFS between the two groups were smaller in the T3–4 subgroup. The univariate analysis showed that T4b disease, neurologic symptoms, longest diameter of tumor, radiological evidence of nerve involvement, and undergoing D(C)RT were associated with worse clinical outcomes, but the significance disappeared in the multivariate analysis, except for in the case of radiological evidence of nerve involvement. In conclusion, most patients with extensive disease underwent upfront D(C)RT and generally exhibited inferior clinical outcomes when compared to those with less extensive disease and who underwent S+PORT.
本研究旨在探讨鼻腔及鼻窦腺样囊性癌（ACC）的治疗模式及预后。回顾性分析了61例鼻窦ACC患者：31例（50.8%）接受手术联合术后放疗（S+PORT），30例（49.2%）接受根治性放疗（D(C)RT）。D(C)RT组T4期病变比例显著更高（25.8% vs. 80.0%，p<0.001），所有T4b期患者均接受D(C)RT治疗。S+PORT组与D(C)RT组的5年局部无复发生存率（LFFS）、无远处转移生存率（DMFS）、无进展生存率（PFS）及总生存率分别为61.8%比37.8%（p=0.003）、64.8%比38.1%（p=0.036）、52.6%比19.3%（p=0.010）及93.2%比73.4%（p=0.001）。在T3-4亚组中，两组间5年LFFS、DMFS及PFS的绝对差异较小。单因素分析显示T4b期病变、神经系统症状、肿瘤最大径、影像学神经侵犯证据及接受D(C)RT治疗与不良临床结局相关，但多因素分析中仅影像学神经侵犯证据保持显著相关性。综上所述，广泛病变患者多接受初始D(C)RT治疗，其临床结局普遍较局限病变接受S+PORT治疗者更差。
肿瘤(癌症)患者之家