Department of Oral and Maxillofacial Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.
Cancer Med. 2023 Feb;12(3):2368-2377. doi: 10.1002/cam4.5065. Epub 2022 Aug 7.
No study has evaluated the impact of regimen on recurrence, metastasis and survival in patients with adenoid cystic carcinoma (ACC). The present study aimed to compare the efficacy of radioactive seed implantation and other regimens in treating ACC, so as to investigate the clinical applicability of radioactive seed implantation and determine the indications for this regimen.
A total of 188 patients with ACC in oromaxillofacial region were allocated to four groups according to the treatment regimen: group 1 was treated with a combination of surgery and I seed therapy, group 2 with a combination of surgery and external radiotherapy, group 3 with surgery, whereas group 4 was untreated. The Kaplan-Meier method was used to assess the survival rates, and the Cox regression analyses were used to identify the associated prognostic factors.
The overall survival rates of 188 patients and groups 1, 2, 3 and 4 were 85.7%, 75%, 68.2% and 37.5%, respectively. Cox regression analysis revealed that age, T stage, N stage and regimen were independent prognostic factors of survival. Amongst patients with primary ACC, the efficacy of radioactive seed implantation was higher in those with perineural invasion than in those without.
Patient age, T stage, N stage and regimen are independent prognostic factors of survival in patients with ACC. Patients treated with surgery combined with postoperative I seed radiotherapy have a higher overall survival rate, and those with perineural invasion are more suitable for radioactive seed implantation therapy.
目前尚无研究评估方案对腺样囊性癌（ACC）患者复发、转移和生存的影响。本研究旨在比较放射性粒子植入与其他方案治疗 ACC 的疗效，以探讨放射性粒子植入的临床适用性并确定其适应证。
188 例口腔颌面部 ACC 患者根据治疗方案分为 4 组：组 1 为手术联合 Ⅰ 粒子治疗，组 2 为手术联合外放疗，组 3 为手术治疗，组 4 为未治疗。采用 Kaplan-Meier 法评估生存率，Cox 回归分析识别相关预后因素。
188 例患者的总生存率和组 1、2、3、4 分别为 85.7%、75%、68.2%和 37.5%。Cox 回归分析显示，年龄、T 分期、N 分期和方案是生存的独立预后因素。在原发性 ACC 患者中，有神经周围侵犯的患者放射性粒子植入的疗效更高。
患者年龄、T 分期、N 分期和方案是 ACC 患者生存的独立预后因素。手术联合术后 Ⅰ 粒子放疗治疗的患者总生存率更高，有神经周围侵犯的患者更适合放射性粒子植入治疗。
