Kaur Jaspreet, Goyal Shikha, Muzumder Sandeep, Bhasker Suman, Mohanti Bidhu Kalyan, Rath Goura Kishore
All India Institute of Medical Sciences, New Delhi, India E-mail :
Asian Pac J Cancer Prev. 2014;15(19):8259-63. doi: 10.7314/apjcp.2014.15.19.8259.
To determine the clinical characteristics, pathological features, local and distant failure patterns in patients with carcinoma of major salivary glands treated with surgery and postoperative radiotherapy (PORT).
We retrospectively reviewed 106 cases of major salivary gland tumor seen at our centre (1998-2008). Sixty five cases of major salivary gland carcinoma were selected for analysis (exclusions: benign, palliative, non-carcinomas). The patient population treated by surgery and PORT was divided into two groups: 1) Patients who underwent surgery and immediate PORT (Primary PORT); 2) Patients with recurrent carcinoma who underwent at least two surgeries and received PORT in the immediate post-operative period of the last performed surgery (Recurrent PORT). Recurrence free survival (RFS) was assessed using the Kaplan-Meier method.
Median age was 35 years with a male: female ratio of 1.3:1. The majority of cancers were located in the parotid gland (86.2%) and the most common histology was mucoepidermoid carcinoma (43%). Thirty nine cases (60%) were primary while 26 (40%) were recurrent. Optimal surgery was performed in 59/65 patients (90.8%). 43 patients (66.2%) underwent neck dissection, of which 14 (32.5%) had nodal metastasis. Overall, 61 (93.8%) patients complied with the prescribed radiotherapy. Median dose of PORT was 60 Gy. Median follow-up was 13.1 months (range 2-70). Relapse free survival was 50.4% at 60 months. Some 12 cases (18.5%) recurred with a median time to recurrence of 16.9 months.
Surgery and PORT is an effective treatment for major salivary gland carcinoma with over 90% compliance and <20% recurrence. Early treatment with postoperative radiotherapy may increase the survival rate in major salivary gland carcinoma patients.
确定接受手术及术后放疗（PORT）的大唾液腺癌患者的临床特征、病理特征、局部和远处失败模式。
我们回顾性分析了1998年至2008年在本中心就诊的106例大唾液腺肿瘤病例。选取65例大唾液腺癌病例进行分析（排除标准：良性、姑息性、非癌性肿瘤）。接受手术及PORT治疗的患者分为两组：1）接受手术并立即进行PORT的患者（原发性PORT）；2）复发性癌患者，至少接受过两次手术，并在最后一次手术的术后立即接受PORT（复发性PORT）。采用Kaplan-Meier法评估无复发生存期（RFS）。
中位年龄为35岁，男女比例为1.3:1。大多数癌症位于腮腺（86.2%），最常见的组织学类型是黏液表皮样癌（43%）。39例（60%）为原发性癌，26例（40%）为复发性癌。59/65例患者（90.8%）接受了最佳手术。43例患者（66.2%）接受了颈部清扫术，其中14例（32.5%）有淋巴结转移。总体而言，61例（93.8%）患者完成了规定的放疗。PORT的中位剂量为60 Gy。中位随访时间为13.1个月（范围2 - 70个月）。60个月时无复发生存率为50.4%。约12例（18.5%）出现复发，中位复发时间为16.9个月。
手术及PORT是治疗大唾液腺癌的有效方法，依从性超过90%，复发率<20%。术后早期放疗可能提高大唾液腺癌患者的生存率。
