頭頸部領域に発生した横紋筋肉腫の4症例

Rhabdomyosarcoma in the Head and Neck: Report of 4 Cases

I．はじめに

　横紋筋肉腫は比較的まれな腫瘍であり，悪性度が高く，病理診断の困難な場合もあり，治療のむずかしい腫瘍である。しかし，最近報告例も多くなり，また，手術療法，化学療法，放射線療法を組み合わせることにより，治療成績立向上している。

　筆者らは，開院以来昭和57年までの5年間に，4例の横紋筋肉腫症例を経験したので，若干の文献的考察を加えて報告する。

　Four patients with rhabdomyosarcoma were presented. The age of these patients were 17, 19, 7, and 6, and all were female. Each tumor was originated from the rhinologic region as follows ; two from the maxillary sinus, and one from soft tissue of the cheek, and one from the nasal vestibule.

　All of them were treated with combination of surgery, radiotherapy, and chemotherapy. As to chemotherapy, Vincristine, Actinomycin D, Cyclophosphamide, etc. were utilized according to the protocol of Intergroup Rhabdomyosarcoma Study. Bone marrow suppression due to these antineoplastic drugs was remarkably observed. Because of these side effects, the protocol of Intergroup Rhabdomyosaroma Study was not accepted to Japanese patients with rhabdomyosarcaoma. Above all, administration of the antineoplastic drugs should be reconsidered in respect of dosage or sequential combination. Of four patients three died of the disease itself, and the mean survival duration of them was 13.3 months. One patient has been alived without recurrence nor metastasis for over five years.