CAJ | 학술논문

目的分析原发鼻咽涎腺型癌临床特点、治疗方法及预后因素.方法回顾分析1963-2006年本院收治的54例原发鼻咽涎腺型癌患者资料,其中腺样囊性癌36例、黏液表皮样癌11例、腺癌7例,单纯手术2例、单纯放疗30例、综合治疗22例(手术加放疗15例,放疗加手术7例).8例接受化疗(术后辅助化疗1例,同期放化疗1例,复发后化疗6例).用Logrank法单因素分析.结果随访率为89％.2、5年总生存率分别为85％、61％,无局部区域失败生存率分别为74％、55％,无远处转移生存率分别为92％、70％.治疗失败35例,其中26例局部区域失败(1例鼻咽复发加颈部淋巴结转移,23例鼻咽复发,2例颈部淋巴结转移).发生远处转移13例(4例出现多脏器转移),其中肺转移10例、肝转移3例、骨转移2例、脑转移1例、皮下转移1例.单因素分析显示病理亚型与总生存率相关(x2=15.29,P=0.000),而颈部淋巴结转移与无远转生存率相关(x2=9.08,P=0.003).结论鼻咽涎腺型癌是一种局部侵袭性强、病程发展相对较慢的疾病,治疗上推荐手术与放疗的综合治疗.
목적 분석원발비인연선형암림상특점、치료방법급예후인소.방법 회고분석1963-2006년본원수치적54례원발비인연선형암환자자료,기중선양낭성암36례、점액표피양암11례、선암7례,단순수술2례、단순방료30례、종합치료22례(수술가방료15례,방료가수술7례).8례접수화료(술후보조화료1례,동기방화료1례,복발후화료6례).용Logrank법단인소분석.결과 수방솔위89％.2、5년총생존솔분별위85％、61％,무국부구역실패생존솔분별위74％、55％,무원처전이생존솔분별위92％、70％.치료실패35례,기중26례국부구역실패(1례비인복발가경부림파결전이,23례비인복발,2례경부림파결전이).발생원처전이13례(4례출현다장기전이),기중폐전이10례、간전이3례、골전이2례、뇌전이1례、피하전이1례.단인소분석현시병리아형여총생존솔상관(x2=15.29,P=0.000),이경부림파결전이여무원전생존솔상관(x2=9.08,P=0.003).결론 비인연선형암시일충국부침습성강、병정발전상대교만적질병,치료상추천수술여방료적종합치료.
Objective To analyze the clinical characteristics , therapeutic outcomes , and prognostic factors of primary salivary gland type nasopharyngeal carcinoma ( SNPC) . Methods The medical records of 54 patients with SNPC at single institution between 1963 and 2006 were reviewed, 2 patients received surgery alone, 30 patients received radiotherapy alone and 22 patients received combined modality therapy consisting of surgery (S) and radiotherapy ( RT) ( S + RT in 15 and RT + S in 7). Of them, 8 patients received chemotherapy , including post-operative adjuvant chemotherapy in 1 patient, palliative chemotherapy in 6 patients and concurrent chemotherapy in 1 patient. 36 patients had adenoid cystic carcinoma ( ACC) ,11 mucoepidermoid carcinoma ( MEC) , and 7 primary traditional adenocarcinoma ( AC) . The Kaplan-Meier method was used to calculate the overall sunival ( OS) , locoregional failure-free survival ( LRFFS) , and distant failure-free survival ( DFFS) rates. Univariate analyses were performed using the Log-rank method.Comparisons of variables between cases were performed using Pearson chi-square test. Results The follow-up was 89％ . The 2-, and 5-year overall survival rates, loco-regional failure free survival rates and distant failure free survival rates were 85％ and 61％ , 74％ and 55％ , 92％ and 70％, respectively. Among the 35 patients with treatment failure, 26 patients had locoregional failure (1 in primary site and cervical lymph node ,23 in primary site and 2 in cervical lymph node) ,and 13 had distant metastasis. The lung was the most common site of metastasis ( n =10) , followed by liver (n = 3), bone ( n = 2) , brain ( n = 1) , and subcutaneous tissue ( n = 1) . Univariate analyses indicated that histological subtypes correlated with overall survival ( X2 = 15. 29, P = 0. 000) and cervial lymph node metastases correlated with distant failure-free survival ( X2 =9. 08 ,P = 0. 003) . Conclusions Primary salivary gland type nasopharyngeal carcinoma is a locally aggressive disease with a long course. The optimal treatment policy for patients with SNPC may be surgery plus radiotherapy.