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腮腺肿瘤的预后因素及临床结局:来自土耳其黑海东部地区一家机构的经验

Prognostic Factors and Clinical Outcome in Parotid Gland Tumors: a Single Institution Experience from the Eastern Black Sea Region of Turkey.

作者信息

Kandaz Mustafa, Soydemir Gulsen, Bahat Zumrut, Canyilmaz Emine, Yoney Adnan

机构信息

Department of Radiation Oncology, Faculty of Medicine, Trabzon, Karadeniz Technical University, Turkey E-mail :

出版信息

Asian Pac J Cancer Prev. 2016;17(3):1169-74. doi: 10.7314/apjcp.2016.17.3.1169.

Abstract

PURPOSE

To review clinical characteristics, treatment outcomes and prognostic factors in patients with parotid gland tumors treated with surgery and postoperative radiotherapy.

MATERIALS AND METHODS

We retrospectively reviewed 69 patients with parotid gland tumors, with a median follow-up of 52 months (range, 2-228 months). and a median radiotherapy dose of 60Gy (range, 30-69 Gy).

RESULTS

There were 24 (35%) females and 45 (65%) males, at a ratio of 1/1.9. Median age at presentation was 58.9±17.2 (range 13-88) years. The most common histology was adenoid cystic carcinoma (33%) and mucoepidermoid carcinoma (28%). The mean overall survival (OS) was 65.3±8 (95% confidence interval [CI], 49.6-81.1) months and the median overall survival was 40.0 ± 7 (95% CI, 26.2-53.7) months. The -1, -3, -5 and -10 year OS rates were 78%, 52.4%, 35.3% and 19.6% respectively. The mean disease free survival (DFS) was 79.2±10 (95% CI, 59.3-97.1) months and the median disease free survival was 38±13 (95% CI, 7.05-88.7) months. The -1,-3,-5 and -10 year DFS rates were 71.9%, 50.1%, 43.7% and 30.1% respectively. On univariate analysis, the OS was significantly better with female sex (p<0.005), < 50 age (p<0.021), T stage (p<0.0001), absence of lymph node involvement (p<0.0001), lower tumor grade (p<0.0001), absence of lymphovascular invasion (p<0.002), absence of perineural invasion (p<0.0001), absence of extracapsuler extension (p<0.0001), surgical margin negativity (p<0.006), ≤60 Gy radiotherapy dose (p<0.0001) and absence of distant metastasis (p<0.027).

CONCLUSIONS

Employing existing standards of postoperative radiotherapy is a possible treatment that was found to be mainly effective in patients with parotid gland carcinomas.

摘要

目的

回顾接受手术及术后放疗的腮腺肿瘤患者的临床特征、治疗结果及预后因素。

材料与方法

我们回顾性分析了69例腮腺肿瘤患者,中位随访时间为52个月(范围2 - 228个月),中位放疗剂量为60Gy(范围30 - 69Gy)。

结果

女性24例(35%),男性45例(65%),男女比例为1/1.9。就诊时的中位年龄为58.9±17.2(范围13 - 88)岁。最常见的组织学类型为腺样囊性癌(33%)和黏液表皮样癌(28%)。平均总生存期(OS)为65.3±8(95%置信区间[CI],49.6 - 81.1)个月,中位总生存期为40.0±7(95%CI,26.2 - 53.7)个月。1年、3年、5年和10年总生存率分别为78%、52.4%、35.3%和19.6%。平均无病生存期(DFS)为79.2±10(95%CI,59.3 - 97.1)个月,中位无病生存期为38±13(95%CI,7.05 - 88.7)个月。1年、3年、5年和10年无病生存率分别为71.9%、50.1%、43.7%和30.1%。单因素分析显示,女性(p<0.005)、年龄<50岁(p<0.021)、T分期(p<0.0001)、无淋巴结受累(p<0.0001)、肿瘤分级较低(p<0.0001)、无脉管侵犯(p<0.002)、无神经侵犯(p<0.0001)、无包膜外扩展(p<0.0001)、手术切缘阴性(p<0.006)、放疗剂量≤60Gy(p<0.0001)及无远处转移(p<0.027)时总生存期显著更好。

结论

采用现有的术后放疗标准是一种可行的治疗方法,发现其对腮腺癌患者主要有效。

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