Gutschenritter Tyler, Machiorlatti Michael, Vesely Sara, Ahmad Bilal, Razaq Wajeeha, Razaq Mohammad
College of Medicine, Department of Medicine - Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, U.S.A.
Department of Biostatistics and Epidemiology, Department of Medicine - Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, U.S.A.
Anticancer Res. 2017 Sep;37(9):5019-5025. doi: 10.21873/anticanres.11916.
Despite adjuvant radiotherapy, survival outcomes remain poor in patients with salivary gland malignancies who have multiple poor prognostic factors. This study aimed to determine which patients may benefit from treatment intensification.
Patients who underwent curative resection with or without adjuvant radiotherapy between 2002 and 2014 were identified and a retrospective chart review was performed. Overall survival (OS) and disease-free survival (DFS) were the main outcomes measured.
A total of 95 patients met the inclusion criteria. The median follow-up was 46.8 months. The median age was 60 years. Radiotherapy was given to 78 patients. Multivariate analysis revealed that male sex and perineural invasion significantly reduced overall and disease-free survival. Distant metastases comprised of 67% of recurrences and 33% were locoregional.
Adjuvant chemoradiotherapy should be considered for patients with tumors with perineural invasion, especially in males with high-risk histopathology or high-grade, late-stage disease. To our knowledge, this is the first study to assess the impact of pack-year smoking history on survival outcomes.
尽管进行了辅助放疗，但具有多种不良预后因素的涎腺恶性肿瘤患者的生存结果仍然较差。本研究旨在确定哪些患者可能从强化治疗中获益。
确定2002年至2014年间接受了根治性切除且接受或未接受辅助放疗的患者，并进行回顾性病历审查。主要测量总生存期（OS）和无病生存期（DFS）。
共有95例患者符合纳入标准。中位随访时间为46.8个月。中位年龄为60岁。78例患者接受了放疗。多变量分析显示，男性和神经周围侵犯显著降低了总生存期和无病生存期。远处转移占复发的67%，局部区域转移占33%。
对于有神经周围侵犯的肿瘤患者，尤其是组织病理学高危或高级别、晚期疾病的男性患者，应考虑辅助放化疗。据我们所知，这是第一项评估吸烟包年史对生存结果影响的研究。
