Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.
Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
BMC Cancer. 2023 Oct 12;23(1):968. doi: 10.1186/s12885-023-11466-1.
There is limited information of radical radiotherapy (RT) on lymphoepithelial carcinoma of salivary gland (LECSG) regarding to the rarity of the disease. We conducted this retrospective study that evaluated the feasibility and efficacy of radical RT with/without surgery in LECSG.
We retrospectively reviewed patients that were pathologically diagnosed of LECSG and had definite or suspicious residual disease. The prescribed dose given to P-GTV and/or P-GTV-LN was 66 to 70.4 Gy. The clinical target volume (CTV) involved ipsilateral salivary gland and corresponding lymph node drainage area.
A total of 56 patients were included. With a median follow-up of 60 months (range: 8 to 151 months), the 1-, 5-, and 10-year progression-free survival (PFS) rates were 94.6%, 84.7% and 84.7%; locoregional progression-free survival (LRPFS) rates were 98.2%, 87.4% and 87.4%; distance metastasis-free survival (DMFS) rates were 94.6%, 86.7% and 86.7%; and overall survival (OS) rates were 98.2%, 92.4% and 89.0%, respectively. A total of 7 patients without surgery were included. All patients were alive and only one patient experienced failure of distant metastasis four months after RT. The results of univariate analysis showed that compared with N stage, the number of positive lymph nodes (2 positive lymph nodes) was better prognostic predictor especially in PFS. There were no treatment-related deaths and most toxicities of RT were mild.
Radical RT with/without surgery in LECSG for definite or suspicious residual disease is feasibility and efficacy. Most toxicities of RT were mild due to the target volume involved ipsilateral area.
由于涎腺淋巴上皮癌（LECSG）发病率低，关于其根治性放疗（RT）的信息有限。我们进行了这项回顾性研究，评估了根治性 RT 联合/不联合手术治疗 LECSG 中明确或可疑残留疾病的可行性和疗效。
我们回顾性分析了经病理诊断为 LECSG 且有明确或可疑残留疾病的患者。计划给予 P-GTV 和/或 P-GTV-LN 的剂量为 66 至 70.4Gy。临床靶区（CTV）包括同侧涎腺及相应淋巴结引流区。
共纳入 56 例患者。中位随访时间为 60 个月（范围：8 至 151 个月），1、5 和 10 年无进展生存率（PFS）分别为 94.6%、84.7%和 84.7%；局部区域无进展生存率（LRPFS）分别为 98.2%、87.4%和 87.4%；远处转移无进展生存率（DMFS）分别为 94.6%、86.7%和 86.7%；总生存率（OS）分别为 98.2%、92.4%和 89.0%。共纳入 7 例未手术患者。所有患者均存活，仅 1 例患者在 RT 后 4 个月出现远处转移失败。单因素分析结果表明，与 N 分期相比，阳性淋巴结数量（2 个阳性淋巴结）是 PFS 的更好预后预测指标。无治疗相关死亡，大多数 RT 毒性反应较轻。
对于明确或可疑残留疾病，LECSG 行根治性 RT 联合/不联合手术是可行和有效的。由于靶区仅累及同侧区域，大多数 RT 毒性反应较轻。
