Tran L, Sidrys J, Horton D, Sadeghi A, Parker R G
Radiation Therapy Service, V.A. Medical Center, West Los Angeles, California 90073.
Am J Clin Oncol. 1989 Oct;12(5):387-92. doi: 10.1097/00000421-198910000-00005.
Between 1962 and 1985, 35 patients with malignant salivary gland tumors of the paranasal sinuses and nasal cavity were treated with curative intent at UCLA. They were staged according to the American Joint Committee (TNM) classification for squamous cell carcinoma of the paranasal sinuses: 27 of 35 (77%) patients presented with T3-4 disease. Adenoid cystic carcinoma was the diagnosis in 24 (68%) patients, while adenocarcinoma accounted for half of the cases involving the ethmoid sinuses and nasal cavity. Eleven patients were treated with surgery alone, 13 with combined surgery and radiation, and 11 with radiation therapy alone. All patients were followed from 40 to 216 months. Analysis by treatment modality revealed a local control of 18% (2 of 11) in the surgery alone group, 62% (8 of 13) in the combined group, and 9% (1 of 11) in the radiation alone group. The group undergoing combined treatment achieved the highest local control rate despite having a higher proportion of patients with advanced stage and residual disease at the surgical margins. In patients with positive surgical margins, the tumor recurred locally in 4 of 6 (67%) unirradiated patients, compared with 3 of 10 (30%) of those undergoing postoperative irradiation. Patients with adenoid cystic carcinoma had poorer results, with only 25% remaining relapse-free, compared with 45% of patients with adenocarcinoma. The 5-, 10-, 15-, and 20-year actuarial survival for all cases was 73%, 60%, 32%, and 20%, respectively. We conclude that post-operative radiation improves the results of treatment in all patients with malignant salivary gland tumors in this location, compared with the results of surgery alone.
1962年至1985年间，加利福尼亚大学洛杉矶分校对35例患有鼻窦和鼻腔恶性涎腺肿瘤的患者进行了根治性治疗。根据美国联合委员会（TNM）对鼻窦鳞状细胞癌的分类标准对他们进行分期：35例患者中有27例（77%）表现为T3 - 4期疾病。24例（68%）患者诊断为腺样囊性癌，而腺癌占累及筛窦和鼻腔病例的一半。11例患者仅接受手术治疗，13例接受手术联合放疗，11例仅接受放疗。所有患者随访40至216个月。按治疗方式分析显示，单纯手术组的局部控制率为18%（11例中的2例），联合治疗组为62%（13例中的8例），单纯放疗组为9%（11例中的1例）。联合治疗组尽管有更高比例的晚期患者和手术切缘残留疾病，但局部控制率最高。手术切缘阳性的患者中，6例未接受放疗的患者中有4例（67%）局部复发，而接受术后放疗的10例患者中有3例（30%）复发。腺样囊性癌患者的结果较差，只有25%的患者无复发，而腺癌患者为45%。所有病例的5年、10年、15年和20年精算生存率分别为73%、60%、32%和20%。我们得出结论，与单纯手术结果相比，术后放疗可改善该部位所有恶性涎腺肿瘤患者的治疗效果。
