Vikram B, Strong E W, Shah J P, Spiro R H
Int J Radiat Oncol Biol Phys. 1984 Feb;10(2):221-3. doi: 10.1016/0360-3016(84)90007-5.
Between 1949 and 1977, 74 patients with adenoid-cystic carcinoma of various head and neck sites were treated by radiation therapy at Memorial Sloan-Kettering Cancer Center. Radiation therapy alone was employed in 49 patients for recurrent, unresectable disease, and in 25 patients it was given as an adjunct to surgical resection. Among the 49 patients treated with radiation therapy alone, tumor regression was seen in 47 (96%). However, 44 of the 47 (93.5%) subsequently relapsed locally. Relapse occurred within 18 months in one-half of the patients and within 5 years in all of them. Of the 25 patients who received adjunctive radiation therapy about one-half relapsed locally within five years. There were 9 patients in this group, however, whose field size exceeded 8 X 8 cm and the dose of radiation also exceeded 4500 rad: 88% of these patients remained relapse-free at 5 years, compared with only 22% of the other 16 whose dose, or field size, or both, were inadequate by comparison. These data suggest that when irradiation is employed for advanced, inoperable adenoid-cystic carcinoma, it offers useful palliation but is rarely, if ever, curative. Postoperative irradiation, on the other hand, might improve the local control and the survival in patients with operable adenoid-cystic carcinoma who are at high risk for relapse, but only if the field size and the dose are adequate.
1949年至1977年间，纪念斯隆凯特琳癌症中心对74例头颈部不同部位腺样囊性癌患者进行了放射治疗。49例复发、无法切除的患者仅接受了放射治疗，25例患者接受了放射治疗作为手术切除的辅助治疗。在仅接受放射治疗的49例患者中，47例（96%）出现肿瘤消退。然而，47例中的44例（93.5%）随后出现局部复发。一半的患者在18个月内复发，所有患者在5年内均复发。在接受辅助放射治疗的25例患者中，约一半在5年内出现局部复发。然而，该组中有9例患者，其照射野尺寸超过8×8 cm，放射剂量也超过4500拉德：这些患者中有88%在5年时无复发，相比之下，其他16例患者中，由于照射剂量或照射野尺寸或两者不足，只有22%无复发。这些数据表明，当对晚期、无法手术的腺样囊性癌采用放射治疗时，它可提供有效的姑息治疗，但很少能治愈。另一方面，术后放射治疗可能会改善有高复发风险的可手术腺样囊性癌患者的局部控制和生存率，但前提是照射野尺寸和剂量足够。
