Tran L, Sadeghi A, Hanson D, Ellerbroek N, Calcaterra T C, Parker R G
Department of Radiation Oncology, Wadsworth VA Medical Center, Los Angeles, CA 90073.
Laryngoscope. 1987 Nov;97(11):1343-5. doi: 10.1288/00005537-198711000-00018.
A retrospective review of 38 patients with salivary gland tumors of the palate treated between 1961 and 1984 is presented. The majority of tumors were identified at an early stage. Most (23 of 38 cases) originated over the hard palate. The most common histological type was adenoid cystic carcinoma (22 cases). Twenty-five patients were treated with surgery alone, of whom, three had wide local excision. Thirteen patients received postoperative radiation therapy in addition to surgery. The local control was comparable for surgery alone and combined therapy (88% and 85%, respectively) although the combined therapy group was biased by more advanced disease, inadequate margins, and/or poorly differentiated histologies. Mucoepidermoid lesions had an excellent prognosis with local control of 100%. In contrast, there was a 23% recurrence rate for adenoid cystic carcinoma. Regional neck node metastasis was noted in 2% of the patients. This experience indicates that radical resection of palate salivary gland malignancy with adequate margins results in excellent local control. Adjuvant radiation therapy is recommended in cases where there is a question of adequate margins and in advanced lesions of high grade tumors.
本文对1961年至1984年间治疗的38例腭部涎腺肿瘤患者进行了回顾性研究。大多数肿瘤在早期被发现。大多数(38例中的23例)起源于硬腭。最常见的组织学类型是腺样囊性癌(22例)。25例患者仅接受手术治疗,其中3例行广泛局部切除。13例患者除手术外还接受了术后放疗。尽管联合治疗组因疾病更晚期、切缘不足和/或组织学分化差而存在偏差,但单纯手术和联合治疗的局部控制率相当(分别为88%和85%)。黏液表皮样病变预后良好,局部控制率为100%。相比之下,腺样囊性癌的复发率为23%。2%的患者出现区域颈部淋巴结转移。该经验表明,对腭部涎腺恶性肿瘤进行足够切缘的根治性切除可实现良好的局部控制。对于切缘是否足够存在疑问的病例以及高级别肿瘤的晚期病变,建议进行辅助放疗。