Weusthof Katharina, Debus Jürgen, Adeberg Sebastian
Universitätsklinikum Heidelberg (UKHD) und Deutsches Krebsforschungszentrum (DKFZ), Nationales Centrum für Tumorerkrankungen (NCT), Im Neuenheimer Feld 460, 69120, Heidelberg, Deutschland.
Abteilung für Radioonkologie, Universitätsklinikum Heidelberg (UKHD), Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland.
HNO. 2023 Apr;71(4):243-249. doi: 10.1007/s00106-022-01188-4. Epub 2022 Jun 10.
Due to their rarity, histologic heterogeneity, and localization, treatment of malignant salivary gland tumors requires an interdisciplinary approach. First-line treatment includes complete tumor resection. Postoperative radiation therapy is advised in patients with risk factors, i.e., incomplete tumor resection, high-grade tumors, or perineural invasion. Definitive radiation therapy is only advised for inoperable tumors because of significantly lower local control and survival rates when compared to combined surgery and radiation therapy. In radiation oncology, modern techniques such as intensity-modulated radiation therapy (IMRT) or particle therapy with heavy ions (i.e., C12) have led to improved outcomes in the treatment of head and neck tumors, especially of adenoid cystic carcinomas. Given the biological and physical benefits of particles, particle therapy, particularly carbon ion radiation, is a promising therapeutic approach for salivary gland tumors that will be further investigated in prospective clinical studies.
由于恶性涎腺肿瘤罕见、组织学异质性及定位特点，其治疗需要多学科方法。一线治疗包括完整肿瘤切除。对于有危险因素的患者，即肿瘤切除不完整、高级别肿瘤或神经周围侵犯，建议术后进行放射治疗。仅对无法手术的肿瘤建议进行根治性放射治疗，因为与手术联合放射治疗相比，其局部控制率和生存率显著降低。在放射肿瘤学中，现代技术如调强放射治疗（IMRT）或重离子（即碳-12）粒子治疗已改善了头颈部肿瘤的治疗效果，尤其是腺样囊性癌。鉴于粒子的生物学和物理优势，粒子治疗，特别是碳离子放射治疗，是涎腺肿瘤一种有前景的治疗方法，将在前瞻性临床研究中进一步研究。
