Tonsillar carcinoma: analyses of the therapy and prognostic factors / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To retrospectively analyze the therapeutic effect on patients with tonsillar carcinoma and factors affecting their prognosis.</p><p><b>METHODS</b>Clinical data of 61 patients pathologically confirmed with tonsillar carcinoma without distant metastasis were analyzed. All the patients were treated in Cancer Center of Sun Yat-sen University from April 1997 to April 2008. There were 2 patients with undifferentiated carcinoma, 26 with poorly differentiated squamous cell carcinoma and 33 with median-well differentiated squamous cell carcinoma. According to the AJCC 2002 staging criteria for head-neck cancers, there were 9 staged I cases, 7 staged II cases, 23 staged III cases and 22 staged IV cases. The treatment was radiotherapy alone in 27 cases, radiotherapy combined with chemotherapy in 23 cases, surgery combined with postoperative radiotherapy in 6 cases, neoadjuvant chemotherapy plus surgery combined with postoperative radiotherapy in 3 cases, radiotherapy with salvage surgery in 2 cases.</p><p><b>RESULTS</b>The overall 5-year survival rate was 50.2%. For 16 cases with staged I-II staged, there were 8 cases with radiotherapy alone, 5 years survival was 50.0%, 6 cases with surgery combined with postoperative radiotherapy, 5 years survival was 83.3%. The difference between the two treatments was not significant in statistics (P = 0.318). For III-IV staged 45 cases, there were 19 cases with simple radiotherapy, 5 years survival was 51.5%, 21 cases with radiotherapy combined with chemotherapy, 5 years survival was 36.4%, 5 cases with surgery combined with postoperative radiotherapy, 5 years survival was 75.0%. The difference among the three treatments was not significant in statistics (P = 0.239). According to T stages, the 5-year survival rates of stage T1-T4 cases were 91.8%, 46.8%, 29.1%, 0% respectively (chi(2) = 30.168, P < 0.001). Multivariate analysis demonstrated that T stage, therapeutic effect of primary site and cervical metastatic lymph node were the independent prognostic factors (P < 0.05).</p><p><b>CONCLUSIONS</b>T stage, the therapeutic effect of primary site and cervical metastatic lymph node were the independent prognostic factors. For I-II staged tonsillar tumor cases, based on organ preservation, were tendency to choice simple radiotherapy. For III-IV staged cases, yet the relationships between therapeutic mode and therapeutic effect still need further researches.</p>

Clinical analysis of 20 adults esthesioneuroblastoma with combined therapy / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To retrospectively compare the survival difference of 20 patients with esthesioneuroblastoma (EN) who received combined therapy, and try to analyze the most optimized modalities.</p><p><b>METHODS</b>Twenty patients of adult ( > or = 14 years) EN received combined therapy in Cancer Center of Sun Yat-sen University from Jan 1998 to Jan 2005. Six patients were staged Kadish B and fourteen patients Kadish C. Twelve of them received induction chemotherapy followed by radiotherapy while the other 8 received surgery followed by adjuvant radiotherapy. The disease free survival and overall survival rate were calculated by Kaplan-Meier method and compared by Log-rank method. And the baseline characteristics was examined by Fisher's exact test.</p><p><b>RESULTS</b>Follow up from beginning of treatment to 31th March, 2008, the 3-year overall survival rate was 50.0%, the 3-year disease free survival and overall survival rates were 16.7%, 25.0% for chemoradiation group and 75.0%, 87.5% for surgery plus radiotherapy group, respectively. The disease free survival and overall survival rate of the latter group were better than the former (chi2 values were 6.81 and 7.33, P values were 0.0091 and 0.0068, respectively).</p><p><b>CONCLUSIONS</b>Surgery combined with adjuvant radiotherapy may increase the survival rate compared with induction chemotherapy followed by radiotherapy for local advanced esthesioneuroblastoma. Active surgery combined with radiotherapy and chemotherapy may further improve the survival of EN.</p>