中华放射肿瘤学杂志
中華放射腫瘤學雜誌
중화방사종류학잡지
CHINESE JOURNAL OF RADIATION ONCOLOGY
2010年
2期
97-100
,共4页
涎腺肿瘤/外科学%涎腺肿瘤/放射疗法%预后
涎腺腫瘤/外科學%涎腺腫瘤/放射療法%預後
연선종류/외과학%연선종류/방사요법%예후
Salivary glands neoplasms / surgery%Salivary glands neoplasms / radiotherapy%Prognosis
目的 腺样囊性癌(ACC)是头颈部少见的恶性肿瘤,本研究分析大涎腺ACC的治疗疗效和预后因素.方法 回顾分析54例大涎腺ACC患者,其中腮腺24例,颌下腺或舌下腺30例.单纯手术治疗26例,术后放疗28例.放疗中位剂量为58 Gy(50～65 Gy).结果 随访率为94%,其中随访时间满5年者35例,术后放疗组和单纯手术组分别为15例和20例.全组5年总生存率为97%,5年局部区域控制率为71%,5年远处转移率为13%(7例均为肺转移),5年无瘤生存率为69%.局部区域失败15例,其中单纯手术组13例,术后放疗组2例.术后放疗组和单纯手术组5年局部区域控制率分别为90%和54%,无瘤生存率分别为85%和55%.单因素和多因素分析均显示术后放疗是影响局部区域控制和无瘤生存率的一个重要预后因素.结论 大涎腺ACC术后放疗与单纯手术相比明显提高了疗效,但远处转移较常见.
目的 腺樣囊性癌(ACC)是頭頸部少見的噁性腫瘤,本研究分析大涎腺ACC的治療療效和預後因素.方法 迴顧分析54例大涎腺ACC患者,其中腮腺24例,頜下腺或舌下腺30例.單純手術治療26例,術後放療28例.放療中位劑量為58 Gy(50～65 Gy).結果 隨訪率為94%,其中隨訪時間滿5年者35例,術後放療組和單純手術組分彆為15例和20例.全組5年總生存率為97%,5年跼部區域控製率為71%,5年遠處轉移率為13%(7例均為肺轉移),5年無瘤生存率為69%.跼部區域失敗15例,其中單純手術組13例,術後放療組2例.術後放療組和單純手術組5年跼部區域控製率分彆為90%和54%,無瘤生存率分彆為85%和55%.單因素和多因素分析均顯示術後放療是影響跼部區域控製和無瘤生存率的一箇重要預後因素.結論 大涎腺ACC術後放療與單純手術相比明顯提高瞭療效,但遠處轉移較常見.
목적 선양낭성암(ACC)시두경부소견적악성종류,본연구분석대연선ACC적치료료효화예후인소.방법 회고분석54례대연선ACC환자,기중시선24례,합하선혹설하선30례.단순수술치료26례,술후방료28례.방료중위제량위58 Gy(50～65 Gy).결과 수방솔위94%,기중수방시간만5년자35례,술후방료조화단순수술조분별위15례화20례.전조5년총생존솔위97%,5년국부구역공제솔위71%,5년원처전이솔위13%(7례균위폐전이),5년무류생존솔위69%.국부구역실패15례,기중단순수술조13례,술후방료조2례.술후방료조화단순수술조5년국부구역공제솔분별위90%화54%,무류생존솔분별위85%화55%.단인소화다인소분석균현시술후방료시영향국부구역공제화무류생존솔적일개중요예후인소.결론 대연선ACC술후방료여단순수술상비명현제고료료효,단원처전이교상견.
Objective Adenoid cystic carcinoma (ACC), a rare malignancy in head and neck region, is predominately found in the salivary glands. Our study is to retrospectively analyze the treatment outcomes and prognostic factors of ACC originated from the major salivary glands. Methods A total of 54 patients diagnosed as ACC were treated in our institution, including 24 cases originated from the parotid gland and 30 from the submandibular or sublingual gland. According to the records, 26 patients received surgery alone and 28 were treated with surgery followed by radiotherapy with a median dose of 58 Gy (range, 50 -65 Gy). Results The Follow-up rate was 94%, and 15 patients from postoperative radiotherapy group and 20 from surgery alone group were followed up more then 5 years. The 5-year overall survival rate, local-regional control rate, distant metastasis rate, and disease-free survival rate were 97%, 71%, 13% and 69%, respectively. Lung metastasis, occurred in 7 patients, was the most common distant failure. Fifteen recurrences were observed, including 13 in surgery alone group and 2 in postoperative radiotherapy group. The 5-year local-regional control and disease-free survival rates were 90% and 85% for patients treated with postoperative radiotherapy, 54% and 55% for those treated with surgery alone. Univariate and multivariate analyses showed that postoperative radiotherapy was the only prognostic factor of local-regional control and survival rates. Other parameters such as nerve involvement did not significantly influence the treatment results. Conclusions Postoperative radiotherapy can improve the prognosis of ACC originate from the major salivary glands compared with surgery alone. Distant metastasis is an obstacle in curing the disease, which indicates the value of systemic treatment.
