Pohar Surjeet, Gay Hiram, Rosenbaum Paula, Klish Darren, Bogart Jeffrey, Sagerman Robert, Hsu Jack, Kellman Robert
Department of Radiation Oncology, State University of New York Upstate Medical University, Syracuse, NY 13210, USA.
Int J Radiat Oncol Biol Phys. 2005 Jan 1;61(1):112-8. doi: 10.1016/j.ijrobp.2004.04.052.
To determine the important clinical/pathologic prognostic factors and optimal treatment of malignant parotid tumors.
This study was a retrospective chart review of 163 patients treated for malignant parotid tumors at two institutions. Of the 163 patients, 91 were treated with surgical resection and radiotherapy (RT), 56 were treated with surgery alone, and 13 were treated with RT alone. The median follow-up was 5.1 years (range, 0-37 years).
Locoregional recurrence occurred in 37% of surgery-only, 11% of surgery plus RT, and 15% of RT-only patients (p = 0.001, Pearson's chi-square test). Cox proportional hazard multivariate analysis revealed that increasing age and higher stage were each statistically significantly (p < 0.05) associated with a poorer overall 5-year survival and cause-specific survival. Only increasing age and the absence of adjuvant RT were shown in Cox proportional hazard multivariate analysis to impact negatively on local failure-free survival.
In Cox proportional hazards multivariate analysis, only increasing age and stage were statistically significant prognostic factors for survival. The addition of RT to surgery did not improve overall survival but did reduce locoregional recurrence and improve local failure-free survival.
确定腮腺恶性肿瘤重要的临床/病理预后因素及最佳治疗方法。
本研究是一项对两家机构中163例接受腮腺恶性肿瘤治疗的患者进行的回顾性病历审查。163例患者中，91例接受了手术切除加放疗（RT），56例仅接受了手术治疗，13例仅接受了放疗。中位随访时间为5.1年（范围0 - 37年）。
单纯手术组局部区域复发率为37%，手术加放疗组为11%，单纯放疗组为15%（p = 0.001，Pearson卡方检验）。Cox比例风险多因素分析显示，年龄增加和分期较高均与5年总生存率及病因特异性生存率较差在统计学上显著相关（p < 0.05）。Cox比例风险多因素分析仅显示年龄增加和未进行辅助放疗对局部无复发生存率有负面影响。
在Cox比例风险多因素分析中，仅年龄增加和分期是生存的统计学显著预后因素。手术加放疗并未改善总生存率，但确实降低了局部区域复发率并提高了局部无复发生存率。
