Glanzmann C, Aberle H G, Burgener F, Willi F, Horst W
Strahlentherapie. 1976 Nov;152(5):395-403.
Of 102 patients irradiated because of a tumor of the salivary glands between 1952 and 1973, 80 cases are evaluated in this paper. 67 tumors were localized in the parotid gland. We found 12 tumors in the submandibular gland, one tumor in the sublingual gland. The tumors turned out to be benign in 17 cases, whereas the remaining 63 tumors evidently proved to be malignant. 28 patients underwent either sole irradiation, or radiation therapy was performed after a subtotal operation the number of the patients only irradiated being very small. In 29 cases radiation therapy followed a radical operation; the remaining 23 patients were sent to us for radiation therapy not earlier than after a single or repeated recurrences following surgical treatment. In 23 patients a local recurrence developed after irradiation. Metastases to the lymph nodes were observed in 24 patients, in 17 cases being already manifest at the beginning of the irradiation. Distant metastases were found in 30 patients, six of these existing already at the beginning of the radiation therapy. Till now, thirty patients died because of their cancerous disease, 13 patients because of intercurrent diseases. The five-year survival recovery rate amounted to 50%, the rate of seven-year survival to 42%. The results of surgery for malignant tumors of the salivary glands are distinctly improved by radiation therapy. Especially the high percentage of recurrences after sole surgical treatment reveals the necessity of postsurgical radiation therapy. For the prevention of local recurrences, however, very high doses have to be delivered to the tumor generally. We recommend 6500 rd as a minimal dose to be applied within five to six weeks. In certain cases, with particularly radioresistant tumors, a local dose of up to 7500 rd may be delivered to a small volume. Irradiation of the highly malignant tumors of salivary glands should encompass the regionary lymph nodes too, even if they are not affected metastatically.
在1952年至1973年间因涎腺肿瘤接受放疗的102例患者中,本文评估了80例。67例肿瘤位于腮腺。我们发现12例肿瘤位于下颌下腺,1例位于舌下腺。17例肿瘤为良性,其余63例肿瘤显然为恶性。28例患者接受了单纯放疗,或在次全切除术后进行了放射治疗,单纯接受放疗的患者数量很少。29例患者在根治性手术后接受了放射治疗;其余23例患者在手术治疗后单次或反复复发后才被送来接受放射治疗。23例患者在放疗后出现局部复发。24例患者出现淋巴结转移,其中17例在放疗开始时就已出现转移。30例患者出现远处转移,其中6例在放疗开始时就已存在。到目前为止,30例患者因癌症死亡,13例患者因并发疾病死亡。五年生存率为50%,七年生存率为42%。放射治疗明显改善了涎腺恶性肿瘤的手术效果。特别是单纯手术治疗后复发率很高,这表明术后放射治疗的必要性。然而,为了预防局部复发,一般必须对肿瘤给予非常高的剂量。我们建议在五到六周内给予6500拉德作为最小剂量。在某些情况下,对于特别抗拒放疗的肿瘤,可对小体积区域给予高达7500拉德的局部剂量。即使区域淋巴结未发生转移,对涎腺高度恶性肿瘤进行放疗时也应包括区域淋巴结。