Kandaz M, Soydemir G, Bahat Z, Canyılmaz E, Yöney A
Department of Radiation Oncology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey.
Indian J Cancer. 2016 Apr-Jun;53(2):274-279. doi: 10.4103/0019-509X.197721.
We reviewed clinical characteristics, treatment outcomes, local and distant failure and prognostic factors in patients with salivary gland carcinoma treated with surgery and postoperative radiotherapy.
We retrospectively reviewed 75 patients with salivary gland cancer. 69 (%92) patients had cancer of the parotid gland, 3 (%4) patients had cancer of the submandibular gland and 3 (%4) patients had cancer of the minor salivary gland. 4 patients underwent postoperative chemoradiotherapy and 71 patients underwent postoperative radiotherapy. Median radiotherapy dose was 60Gy (range, 30Gy to 69Gy).
Median age was 59.6±17.9 (13-88) and the female/male ratio was 1/1.7. Median follow-up 52 months (2-228 months). The mean overall survival 69.2±8 (95%confidence interval[CI], 53.4-85.1) months. The 1-,3-,5- and 10- year overall survival rates were 79.8%, 53.2%, 37.4% and 22.8% respectively. The mean disease free survival 79.7±10 (95%CI, 60.1-99.3) months. The 1-,3-,5- and 10- year disaese free survival rates were 72.8%, 51.9%, 44.1% and 30.4% respectively. On multivariate analysis, the OS was significantly better for the female sex (hazard ratio[HR]:3,0;95%CI:1.5-5.6;P=0.001), absence of lymph node involvement ([HR]:3,0;95%CI:1.7-5.3;P=0.0001), lower tumor grade ([HR]:25,7;95%CI:3.3-199.3;P=0.002), negativity of the surgical margin ([HR]:2,3;95%CI:1.3-4.2;P=0.005), absence of lymphovasculer invasion ([HR]:2,6;95%CI:1.5-4.6;P=0.001), absence of extracapsuler extension ([HR]:6,5;95%CI:2.2-19.1;P=0.001), absence of perineural invasion ([HR]:4,8;95%CI:2.6-8.7;P=0.0001) and ≤60Gy radiotherapy dose ([HR]:3,1;95%CI:1.7-5.5;P=0.0001). They observed local recurrens in17 (23%) patients and distant metastasis in 33 (44%) patients.
Employing existing standards of postoperative radiotherapy is a possible treatment that was found to be effective mainly in patients with salivary gland carcinomas.
我们回顾了接受手术及术后放疗的涎腺癌患者的临床特征、治疗结果、局部和远处复发情况以及预后因素。
我们回顾性分析了75例涎腺癌患者。其中69例（92%）为腮腺癌，3例（4%）为下颌下腺癌，3例（4%）为小涎腺癌。4例患者接受了术后放化疗，71例患者接受了术后放疗。中位放疗剂量为60Gy（范围30Gy至69Gy）。
中位年龄为59.6±17.9（13 - 88岁），女性/男性比例为1/1.7。中位随访时间为52个月（2 - 228个月）。平均总生存期为69.2±8（95%置信区间[CI]，53.4 - 85.1）个月。1年、3年、5年和10年总生存率分别为79.8%、53.2%、37.4%和22.8%。平均无病生存期为79.7±10（95%CI，60.1 - 99.3）个月。1年、3年、5年和10年无病生存率分别为72.8%、51.9%、44.1%和30.4%。多因素分析显示，女性的总生存期显著更好（风险比[HR]：3.0；95%CI：1.5 - 5.6；P = 0.001），无淋巴结受累（[HR]：3.0；95%CI：1.7 - 5.3；P = 0.0001），肿瘤分级较低（[HR]：25.7；95%CI：3.3 - 199.3；P = 0.002），手术切缘阴性（[HR]：2.3；95%CI：1.3 - 4.2；P = 0.005），无脉管侵犯（[HR]：2.6；95%CI：1.5 - 4.6；P = 0.001），无包膜外扩展（[HR]：6.5；95%CI：2.2 - 19.1；P = 0.001），无神经侵犯（[HR]：4.8；95%CI：2.6 - 8.7；P = 0.0001）以及放疗剂量≤60Gy（[HR]：3.1；95%CI：1.7 - 5.5；P = 0.0001）。他们观察到17例（23%）患者出现局部复发，33例（44%）患者出现远处转移。
采用现有的术后放疗标准是一种可行的治疗方法，主要对涎腺癌患者有效。
