Simpson J R, Matsuba H M, Thawley S E, Mauney M
Laryngoscope. 1986 Aug;96(8):904-7. doi: 10.1002/lary.1986.96.8.904.
The treatment outcome of 47 patients with adenocarcinoma of major and minor salivary gland origin treated at the Washington University Medical Center between 1960 and 1980 was retrospectively reviewed by site, histologic grade, and treatment modality. Planned irradiation with surgery was the initial treatment for 21 patients, irradiation alone for 14 patients, surgery alone for 11 patients, and chemotherapy for 1. Four patients presented with distant metastases at diagnosis and were not treated definitively. Twenty-seven patients had tumors histologically graded at the time of original treatment; one-third of these were low-grade, and two-thirds were high grade. Treatment results were analyzed in terms of local control as well as overall survival. Median survival for the entire group was 4.1 years. Local-regional disease control was significantly improved in the combination therapy group (81%) compared with the groups treated with irradiation alone (29%) and surgery alone (8%). Disease free survival was also significantly improved with combination therapy. Patients with low-grade adenocarcinoma had better local control and survived longer than those with high-grade. However, one-third of the patients with high-grade tumors survived 5 years. We conclude that both local disease control and survival of patients with adenocarcinoma of salivary gland origin were improved with the planned combination of irradiation and surgery.
对1960年至1980年间在华盛顿大学医学中心接受治疗的47例大、小涎腺来源腺癌患者的治疗结果，按部位、组织学分级和治疗方式进行了回顾性分析。21例患者的初始治疗为计划性放疗联合手术，14例患者仅接受放疗，11例患者仅接受手术，1例患者接受化疗。4例患者在诊断时出现远处转移，未接受确定性治疗。27例患者在初始治疗时对肿瘤进行了组织学分级；其中三分之一为低级别，三分之二为高级别。从局部控制和总生存率方面分析了治疗结果。整个组的中位生存期为4.1年。与单纯放疗组（29%）和单纯手术组（8%）相比，联合治疗组的局部区域疾病控制率显著提高（81%）。联合治疗的无病生存率也显著提高。低级别腺癌患者的局部控制更好，生存期比高级别患者更长。然而，三分之一的高级别肿瘤患者存活了5年。我们得出结论，计划性放疗与手术联合可改善涎腺来源腺癌患者的局部疾病控制和生存率。
