He Yi-Peng, Zhou Ping, Guan Li-Mei, Wu San-Gang
Department of Radiation Oncology, Xiamen Cancer Center, Xiamen Key Laboratory of Radiation Oncology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, People's Republic of China.
Department of Radiation Oncology, Fudan University Shanghai Cancer Center Xiamen Hospital, Xiamen, People's Republic of China.
Ann Med. 2025 Dec;57(1):2445186. doi: 10.1080/07853890.2024.2445186. Epub 2024 Dec 21.
To investigate the incidence of submandibular gland (SMG) involvement and explore the feasibility of sparing SMG in the oral cavity squamous cell carcinoma (OSCC).
This study retrospectively analyzed patients between January 2018 to October 2022. Ten patients with tongue squamous cell carcinoma receiving postoperative radiotherapy were replanned to investigate the feasibility of sparing SMG. The dose constraint for the SMG was a mean dose (Dmean) <39 grey (Gy).
A total of 238 patients were identified and 105 had metastatic neck lymph nodes. Level II was the most common site of metastasis ( = 94, 89.5%), followed by level IB ( = 37, 35.2%), level III ( = 26, 24.8%), level IA ( = 3, 2.6%), and level IV ( = 2, 1.9%). A total of 50 metastatic lymph nodes were located at the level IB, of which 18 (36.0%), 29 (58.0%), and 3 (6%) were located in the lateral, anterior, and inferior aspect of the SMG. No metastatic lymph nodes were found within or on the medial aspect of the SMG. The Dmean of the SMG was <39 Gy in all patients with a Dmean of 38.8 Gy. The median dose of PTV54 D95% was 53.8 Gy, which met the prespecified allowable coverage goal.
Our study suggests that SMG involvement is rare in OSCC. With strict imaging and clinical evaluation, sparing SMG during radiotherapy is feasible.
探讨下颌下腺（SMG）受累的发生率，并探索在口腔鳞状细胞癌（OSCC）中保留SMG的可行性。
本研究回顾性分析了2018年1月至2022年10月期间的患者。对10例接受术后放疗的舌鳞状细胞癌患者重新制定计划，以研究保留SMG的可行性。SMG的剂量限制为平均剂量（Dmean）<39戈瑞（Gy）。
共纳入238例患者，其中105例有颈部淋巴结转移。Ⅱ区是最常见的转移部位（n = 94，89.5%），其次是ⅠB区（n = 37，35.2%）、Ⅲ区（n = 26，24.8%）、ⅠA区（n = 3，2.6%）和Ⅳ区（n = 2，1.9%）。共有50个转移淋巴结位于ⅠB区，其中18个（36.0%）、29个（58.0%）和3个（6%）分别位于SMG的外侧、前侧和下方。在SMG内侧或其上面未发现转移淋巴结。所有患者SMG的Dmean均<39 Gy，平均为38.8 Gy。PTV54 D95%的中位剂量为53.8 Gy，达到了预先设定的可接受覆盖目标。
我们的研究表明，OSCC中SMG受累罕见。通过严格的影像学和临床评估，放疗期间保留SMG是可行的。
