Journal of Prevention and Treatment for Stomatological Diseases ›› 2019, Vol. 27 ›› Issue (9): 545-550.DOI: 10.12016/j.issn.2096-1456.2019.09.001

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Diagnosis and treatment of head and neck osteosarcoma

JI Tong()   

  1. Department of Oral and Maxillofacial Head and Neck Oncology, Shanghai Ninth People’s Hospital, College of Stomatology, Shanghai Jiao Tong University, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, National Clinical Research Center of Stomatology, Shanghai 200011, China
  • Received:2019-03-31 Revised:2019-05-15 Online:2019-09-20 Published:2019-09-20
  • Contact: Tong JI

头颈部骨肉瘤的诊断与治疗

季彤()   

  1. 上海交通大学医学院附属第九人民医院口腔颌面-头颈肿瘤科,上海市口腔医学重点实验室,上海市口腔医学研究所,国家口腔疾病临床研究中心,上海 (200011)
  • 通讯作者: 季彤
  • 基金资助:
    上海申康医院发展中心市级医院新兴前沿技术联合攻关项目(SHDC22017101);国家自然科学基金项目(81671009)

Abstract:

Osteosarcoma is the most common osteogenic malignancy of the head and neck, and its incidence in the upper mandible is predominant. Osteosarcoma of the head and neck has various causes and rich pathological subtypes. Diagnosis of osteosarcoma requires the synthesis of symptoms and imaging data and pathological characteristics (including cell characteristics, immunohistochemical characteristics and molecular markers). Surgery is the core treatment for osteosarcoma of the head and neck. Compartment resection based on the Enneking staging system has high practicability in the surgical treatment of osteosarcoma of the head and neck. Osteosarcoma can be treated by combined craniomandibular surgery to achieve complete resection of the tumor. The combination of adjuvant radiotherapy, adjuvant chemotherapy and surgery can further reduce the risk of local recurrence and distant tumor metastasis. The emergence of targeted therapy and immunotherapy provides more options for the treatment of head and neck osteosarcoma. This article reviews the diagnosis and treatment of osteosarcoma of the head and neck.

Key words: head and neck osteosarcoma, jaws, diagnosis, compartment resection, adjuvant radiotherapy, adjuvant chemotherapy, targeted therapy, prognosis

摘要:

骨肉瘤是头颈部最常见的骨源性恶性肿瘤,以上下颌骨发病为主。头颈部骨肉瘤发病原因多样且病理学亚型丰富,其诊断需综合临床表现、影像学资料、病理学特征(包含细胞特点、免疫组化特点以及分子标记物等信息)后综合得出。手术是头颈部骨肉瘤的核心治疗措施,基于Enneking分期系统的肿瘤间室切除(compartment resection)在头颈部骨肉瘤手术治疗中具有较高实用性:以头颈部原有解剖结构为屏障,将瘤体包绕于周围正常解剖结构内一并切除;对于颅底骨肉瘤,则可采取颅颌联合手术,力求肿瘤完整切除。辅助放疗、辅助化疗与手术的联合使用则可进一步降低肿瘤局部复发及远处转移风险;靶向治疗、免疫治疗等新兴治疗措施的出现为头颈部骨肉瘤的治疗提供了更多选择。本文就头颈部骨肉瘤的诊断与治疗作一述评。

关键词: 头颈部骨肉瘤, 颌骨, 诊断, 间室切除, 辅助放疗, 辅助化疗, 靶向治疗, 预后

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