Objective: To analyze the clinical characteristics and prognosis of newly diagnosed localized head and neck rhabdomyosarcoma. Methods: Cases of newly diagnosed localized head and neck rhabdomyosarcoma between January 2006 and December 2016 were analyzed retrospectively. The clinical features of the patients were described. The Kaplan-Meier method was used to analyze the survival rate under different combined modality therapy and the survival rate with or without chemotherapy. The prognostic factors were analyzed by Cox model. Results: A total of 46 patients were included in this study. Among them, the median follow-up time was 77 months and the median relapse free survival time was 13 months. The relapse free survival time of 5 cases with inadequate local treatment and without combined chemotherapy was 5 months as control, and it was 7 months (P=0.110) in 11 cases with adequate local treatment without combined chemotherapy. Then in 7 cases with inadequate local treatment combined with chemotherapy and 23 cases with adequate local treatment combined with chemotherapy, it was 13 months (P=0.007) and 21 months (P<0.001), respectively. The median relapse-free survival time of chemotherapy patients was significantly longer than that of those without chemotherapy (21 vs 6 months, P=0.018). The effect of combined modality therapy was evaluated according to the adequacy of local treatment and whether to receive systemic chemotherapy, and the combined modality therapy degree was the independent prognostic factor in Cox's proportional hazards regression model (P=0.004). Conclusions: Rhabdomyosarcoma in head and neck is a highly malignant tumor with high relapse rate and easy metastasis. In patients with tolerable condition, systemic chemotherapy and adequate combined modality therapy are recommended to improve relapse-free survival.
目的： 分析初治局限期头颈部横纹肌肉瘤患者的临床特点以及预后因素。 方法： 回顾性分析2006年1月至2016年12月中国医学科学院肿瘤医院46例初治局限期头颈部横纹肌肉瘤患者资料。对患者临床特征进行描述，Kaplan－Meier法分析不同综合治疗下的生存率以及有无化疗时的生存率，使用Cox模型进行预后因素分析。 结果： 46例患者纳入研究。中位随访77个月，中位无复发生存13个月。以不充分局部治疗未联合化疗者5例的无复发生存时间(5个月)作为对照，局部治疗充分未联合化疗者11例的无复发生存时间为7个月(P＝0.110)，局部治疗不充分联合化疗者7例和局部治疗充分联合化疗者23例的无复发生存时间分别是13个月(P＝0.007)和21个月(P<0.001)。化疗者中位无复发生存时间明显长于未行化疗者(21比6个月，P＝0.018)。根据患者局部治疗是否充分及是否接受全身化疗评价患者综合治疗效果，多因素Cox回归模型分析结果显示，综合治疗程度是预后独立影响因素(P＝0.004)。 结论： 头颈部横纹肌肉瘤是高度恶性肿瘤，复发率高，易发生远处转移，在患者可耐受的情况下，推荐全身化疗及充分的综合治疗以改善患者无复发生存。.
Keywords: Combined modality therapy; Drug therapy; Head and neck neoplasms; Prognosis; Rhabdomyosarcoma.