Liu Rui, Shi Ji-Tong, Ge Xin, Yang Ben-Tao, Zhang Hong, Zhang Jing-Xue, Ma Jian-Min
Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing 100730, China.
Int J Ophthalmol. 2021 Apr 18;14(4):547-553. doi: 10.18240/ijo.2021.04.11. eCollection 2021.
To evaluate the survival outcomes of patients with lacrimal gland adenoid cystic carcinoma who underwent eye-sparing surgery combined with I seed implantation radiotherapy or local external γ-ray radiotherapy.
In this retrospective comparative case series, the clinical records of 27 primary and 8 recurrent patients were reviewed. Univariate and multivariate analyses were used to identify risk factors associated with distant metastasis (DM), and the overall survival (OS) after the initial surgery was analyzed.
The median follow-up after radiotherapy was 36mo (range 6-120mo). At the last follow-up after radiotherapy, 26 (74.3%) patients had no evidence of disease, 7 (20%) patients had DM, 2 (5.9%) patients died of DM, and 1 patient with DM was lost to follow-up. Univariate analyses showed that duration of symptoms, bone destruction, T stage classification, and wide excision surgery were risk factors influencing DM (<0.05). The 5-year and 10-year OS rates after the initial surgery were 95.8% and 79.9%, respectively. The 5-year DM-free survival and disease-free survival rates after radiotherapy were 66.4% and 52.7%, respectively.
I seed radiotherapy and local external γ-ray radiotherapy may have similar therapeutic effects in preventing DM. Patients with T1/T2 stage disease have a better prognosis than those with T3/T4 stage disease.
评估接受保眼手术联合碘-125粒子植入放疗或局部外照射γ射线放疗的泪腺腺样囊性癌患者的生存结局。
在这个回顾性比较病例系列中，回顾了27例原发性和8例复发性患者的临床记录。采用单因素和多因素分析来确定与远处转移（DM）相关的危险因素，并分析初次手术后的总生存期（OS）。
放疗后的中位随访时间为36个月（范围6 - 120个月）。在放疗后的最后一次随访时，26例（74.3%）患者无疾病证据，7例（20%）患者发生DM，2例（5.9%）患者死于DM，1例发生DM的患者失访。单因素分析显示，症状持续时间、骨质破坏、T分期分类和广泛切除手术是影响DM的危险因素（<0.05）。初次手术后的5年和10年总生存率分别为95.8%和79.9%。放疗后的5年无DM生存率和无病生存率分别为66.4%和52.7%。
碘-125粒子放疗和局部外照射γ射线放疗在预防DM方面可能具有相似的治疗效果。T1/T2期疾病患者的预后优于T3/T4期疾病患者。
