Fitzpatrick P J, Theriault C
Int J Radiat Oncol Biol Phys. 1986 Oct;12(10):1743-7. doi: 10.1016/0360-3016(86)90314-7.
A retrospective review of 403 patients with salivary gland tumors seen between 1958 and 1980 and a mean follow-up of 10 years is reported. The median age was 58 (7-94) years and the male to female ratio 1.3:1. There were 293 (72%) parotid, 83 (21%) submaxillary and 27 (7%) tumors developed at other sites. Among these were 84 (22%) mucoepidermoid (all degrees of differentiation), 87 (22%) adenocystic carcinomas, 70 (17%) adenocarcinomas, 25 (6%) acinic, 26 (6%) squamous cell, 44 (11%) undifferentiated, 52 (13%) mixed and 12 (3%) nonspecified carcinomas. A painless lump was the first symptom in 338 (84%) patients. The first planned treatment was surgery in 110 (27%), radiotherapy in 50 (12%), and surgery and radiotherapy combined in 239 (59%) patients. Following the first treatment, the primary parotid tumor was controlled by surgery in 17/70 (24%), by irradiation in 6/39 (15%) and surgery and radiation combined in 134/182 (74%) patients. Altogether, regional metastases developed in 36 (12%) and distant metastases in 36 (12%) of 293 patients with parotid tumors. For the submandibular tumors the primary tumor was controlled by surgery in 9/31 (29%), 0/4 (0%) by irradiation, and in 32/46 (70%) by surgery and irradiation. Here, regional and distant metastases developed in 16/84 (19%) and 19/84 (23%) patients. Among the other sites the primary tumor was controlled by surgery in 4/9 (44%), 0/7 (0%) by irradiation, and in 8/11 (73%) by surgery and radiotherapy combined. In this group 4/27 (15%) and 5/27 (18%) patients developed regional and distant metastases. The 5- and 10-year cause specific survival rates were 65 and 59% for the parotid tumors, 61 and 48% for the submaxillary tumors and 62 and 52% for the other sites. These results clearly demonstrate the advantages of combining surgery and radiotherapy as the first planned treatment for most tumors.
报告回顾性分析了1958年至1980年间收治的403例涎腺肿瘤患者，平均随访10年。患者年龄中位数为58岁（7 - 94岁），男女比例为1.3:1。其中293例（72%）肿瘤发生于腮腺，83例（21%）发生于颌下腺，27例（7%）发生于其他部位。这些肿瘤包括84例（22%）黏液表皮样癌（各分化程度）、87例（22%）腺样囊性癌、70例（17%）腺癌、25例（6%）腺泡细胞癌、26例（6%）鳞状细胞癌、44例（11%）未分化癌、52例（13%）混合癌和12例（3%）未明确分类的癌。338例（84%）患者首发症状为无痛性肿块。首次计划治疗中，110例（27%）患者接受手术，50例（12%）患者接受放疗，239例（59%）患者接受手术联合放疗。首次治疗后，腮腺原发性肿瘤通过手术控制的有17/70例（24%），通过放疗控制的有6/39例（15%），通过手术联合放疗控制的有134/182例（74%）。293例腮腺肿瘤患者中，共有36例（12%）发生区域转移，36例（12%）发生远处转移。颌下腺肿瘤患者中，原发性肿瘤通过手术控制的有9/31例（29%），通过放疗控制的为0/4例（0%），通过手术联合放疗控制的有32/46例（70%）。该组患者中，16/84例（19%）发生区域转移，19/84例（23%）发生远处转移。其他部位肿瘤患者中，原发性肿瘤通过手术控制的有4/9例（44%），通过放疗控制的为0/7例（0%），通过手术联合放疗控制的有8/11例（73%）。该组患者中，4/27例（15%）发生区域转移，5/27例（18%）发生远处转移。腮腺肿瘤患者的5年和10年病因特异性生存率分别为65%和59%，颌下腺肿瘤患者分别为61%和48%，其他部位肿瘤患者分别为62%和52%。这些结果清楚地表明，对于大多数肿瘤，手术联合放疗作为首次计划治疗具有明显优势。
