Rodriguez-Bigas M A, Sako K, Razack M S, Shedd D P, Bakamjian V Y, Castillo N B, Rao U
Department of Head and Neck Surgery, Roswell Park Memorial Institute, Buffalo, New York 14263.
J Surg Oncol. 1989 Oct;42(2):92-5. doi: 10.1002/jso.2930420205.
Recurrent salivary gland malignancies present difficult therapeutic decisions and poor prognosis in many instances, and treatment becomes of a palliative nature only. As many of the salivary gland malignancies we see are of the recurrent type, the following study was done to determine the efficacy of a vigorous attempt at retreatment. During the period January 1, 1960, through December 31, 1984, 352 patients with major and minor salivary gland tumors were evaluated at our institution. There were 149 benign lesions and 203 patients with malignant tumors. Of these, 99 patients had recurrent and metastatic tumors that had been treated initially elsewhere. Thirty-three of these patients were able to be treated with curative intent: surgery, 21; surgery plus radiation, 9; radiation therapy alone, 2; and radiation plus chemotherapy, 1. The 5 year survival with no evidence of disease was achieved in three patients with surgery alone and two patients with surgery plus radiation therapy. The group of five patients was comprised of two patients with adenoid cystic carcinomas of the parotid, one with intermediate grade mucoepidermoid carcinoma of the parotid, one, sebaceous cell carcinoma of the parotid, and one, adenoid cystic carcinoma of an accessory salivary gland. The results of this study serve to re-emphasize the relative poor yield of attempts at retreatment of loco-regional recurrence of salivary gland tumors.
复发性涎腺恶性肿瘤在许多情况下呈现出艰难的治疗决策且预后不佳,治疗往往仅具有姑息性质。鉴于我们所见到的许多涎腺恶性肿瘤都是复发性的,故开展了以下研究以确定积极尝试再次治疗的疗效。在1960年1月1日至1984年12月31日期间,我们机构对352例大涎腺和小涎腺肿瘤患者进行了评估。其中有149例良性病变以及203例恶性肿瘤患者。在这些患者中,99例有复发和转移瘤,他们最初在其他地方接受过治疗。其中33例患者能够接受根治性治疗:手术治疗21例;手术加放疗9例;单纯放疗2例;放疗加化疗1例。仅接受手术治疗的3例患者以及接受手术加放疗的2例患者实现了无疾病证据的5年生存率。这5例患者包括2例腮腺腺样囊性癌患者、1例腮腺中度黏液表皮样癌患者、1例腮腺皮脂腺癌患者以及1例副涎腺腺样囊性癌患者。本研究结果再次强调了涎腺肿瘤局部区域复发再次治疗的相对低成功率。