Department of Oral and Maxillofacial Surgery, Peking University School of Stomatology, Beijing, China.
Department of Oral and Maxillofacial Surgery, Peking University School of Stomatology, Beijing, China.
Brachytherapy. 2021 Mar-Apr;20(2):383-392. doi: 10.1016/j.brachy.2020.09.017. Epub 2020 Dec 9.
The purpose of this study was to analyze the effectiveness and safety of the combination of surgery plus postoperative iodine-125 interstitial brachytherapy for treatment of adenoid cystic carcinoma (ACC) of the parotid.
This study included a retrospective analysis of the data of patients who underwent postoperative iodine-125 interstitial brachytherapy for histology-confirmed ACC of the parotid between January 2002 and November 2018 in Peking University Hospital of Stomatology. Acute and long-term radiation-related toxicities were assessed by the criteria of the Radiation Therapy Oncology Group and European Organization for Research and Treatment of Cancer. Multivariate analysis was used to identify the factors affecting overall survival, disease-free survival (DFS), and distant metastasis-free survival (DMFS).
A total of 86 patients (53 women; median age 50 years, SD = 13.1) were included. Median followup was for 45.5 months. About half the patients (44/86, 51.3%) had clinical stage IV disease. Local recurrence occurred in 11 of 86 (12.8%) patients. No patient had nodal metastases in the followup period. The five- and 10-year DFS rates were 74.8% and 66.6%, respectively. The mean DMFS was 60.6 months. On multivariate analysis, preoperative facial palsy, type of surgery, perineural spread (PNS), and distant metastases were independent prognostic factors for DFS; preoperative facial palsy, nodal metastases, and PNS were independent prognostic factors for overall survival; and preoperative facial palsy, type of surgery, PNS, and pathological type were independent prognostic factor for DMFS.
The combination of surgery and iodine-125 interstitial brachytherapy appears to be an effective and safe treatment for primary ACC of the parotid.
本研究旨在分析手术联合术后碘-125 间质内放疗治疗腮腺腺样囊性癌（ACC）的疗效和安全性。
本研究回顾性分析了 2002 年 1 月至 2018 年 11 月期间在北京大学口腔医院接受术后碘-125 间质内放疗的经组织学证实的腮腺 ACC 患者的数据。采用放射治疗肿瘤学组和欧洲癌症研究与治疗组织的标准评估急性和长期放射性相关毒性。采用多变量分析确定影响总生存率、无病生存率（DFS）和无远处转移生存率（DMFS）的因素。
共纳入 86 例患者（53 例女性；中位年龄 50 岁，标准差=13.1）。中位随访时间为 45.5 个月。约一半的患者（44/86，51.3%）为临床 IV 期疾病。86 例患者中有 11 例（12.8%）发生局部复发。随访期间无患者发生淋巴结转移。5 年和 10 年 DFS 率分别为 74.8%和 66.6%。平均 DMFS 为 60.6 个月。多变量分析显示，术前面神经瘫痪、手术类型、神经周围侵犯（PNS）和远处转移是 DFS 的独立预后因素；术前面神经瘫痪、淋巴结转移和 PNS 是总生存率的独立预后因素；而术前面神经瘫痪、手术类型、PNS 和病理类型是 DMFS 的独立预后因素。
手术联合碘-125 间质内放疗似乎是治疗腮腺原发性 ACC 的一种有效且安全的方法。
