Demiroz Abakay Candan, Şahintürk Kadriye, Türk Ali, Özkan Lütfi, Özmen Afşin
Department of Radiation Oncology Medical Faculty of Uludağ University, 16059 Görükle, Bursa, Turkey.
Kulak Burun Bogaz Ihtis Derg. 2014 Nov-Dec;24(6):316-23. doi: 10.5606/kbbihtisas.2014.00344.
This study aims to evaluate our single center experience in patients with a salivary gland tumor receiving postoperative radiation therapy (RT).
Between January 1996 and December 2011, the records of 34 salivary gland tumor patients who were operated and referred to our clinic for adjuvant RT were retrospectively analyzed. Radiation therapy was applied to the primary tumor and lymphatics at a median dose of 60 Gy (54 to 60 Gy) with 1.8-2 Gy/fraction.
The median follow-up was 38 months (range, 3 to 204 months). The most common site of involvement was the parotid gland in 21 patients (62%), followed by the submandibular gland in 11 patients (%24) and minor salivary gland in two patients (9%). Five-year overall survival (OS) was 49% (range, 3 to 206 months) and disease free survival (DFS) was 61% (range, 1 to 173 months). Six patients had local or regional recurrences (18%), while 13 patients (38%) had distant metastasis. A tumor size larger than 4 cm, over six weeks referral time to RT, and existence of metastatic lymph node were found to be poor prognostic factors for OS (p=0.023, p=0.039, respectively), and DFS (p=0.046). While extracapsular involvement significantly reduced the DFS and OS (p=0.022, p=0.050, respectively), overall RT time affected DFS alone (p=0.046).
We recommend adjuvant RT in high-risk patients operated due to a salivary gland tumor.
本研究旨在评估我们单中心对涎腺肿瘤患者进行术后放射治疗（RT）的经验。
回顾性分析1996年1月至2011年12月期间34例接受手术并转诊至我院进行辅助RT的涎腺肿瘤患者的记录。对原发肿瘤和淋巴管进行放射治疗，中位剂量为60 Gy（54至60 Gy），每次分割剂量为1.8 - 2 Gy。
中位随访时间为38个月（范围3至204个月）。最常见的受累部位是腮腺，共21例（62%），其次是颌下腺11例（24%），小涎腺2例（9%）。5年总生存率（OS）为49%（范围3至206个月），无病生存率（DFS）为61%（范围1至173个月）。6例患者出现局部或区域复发（18%），13例患者（38%）出现远处转移。肿瘤大小大于4 cm、RT转诊时间超过6周以及存在转移淋巴结被发现是OS（分别为p = 0.023，p = 0.039）和DFS（p = 0.046）的不良预后因素。虽然包膜外侵犯显著降低了DFS和OS（分别为p = 0.022，p = 0.050），但总的RT时间仅影响DFS（p = 0.046）。
我们建议对因涎腺肿瘤接受手术的高危患者进行辅助RT。
