摘要
目的分析头颈部腺样囊性癌患者的预后及其影响因素。方法回顾性分析2004-2012年我院收治的55例头颈部腺样囊性癌患者的临床资料,其中单纯手术30例,手术加术后放疗22例,放化疗1例,单纯放疗2例,接受化疗15例。接受化疗的15例患者中初治后发生转移行化疗12例,术后同步化放疗2例,同期放化疗1例。采用Kaplan-Meier法和Logrank检验分析其临床疗效和预后情况。结果 55例患者的随访率为96%,中位随访时间46个月。3年、5年总生存率分别为89.8%、77.3%,无远处转移生存率分别为81.8%、35.9%,无局部区域失败生存率分别为79.1%、56.3%。单因素分析显示T分期、术后放疗和手术切缘与总生存率相关(P<0.05),手术切缘和术后放疗与无局部区域失败生存率相关(P<0.05)。多因素分析显示T分期是总生存率的独立影响因素(P=0.005),手术切缘是无局部区域失败生存率的独立影响因素(P=0.047)。结论头颈部腺样囊性癌治疗应尽量手术根治切除,局部晚期推荐手术及放疗综合治疗。
Objective To analyze the prognosis and influence factors of adenoid cystic carcinoma （ACC） of the head and neck. Methods The medical records of 55 patients diagnosed with ACC of the head and neck at our institution from 2004 to 2012 were reviewed. Of these patients, 30 received surgery alone, 22 received postoperative radiotherapy, one received radiotherapy and concurrent chemotherapy, and two received radiotherapy alone. Fifteen patients received chemotherapy, including palliative chemotherapy for 12 patients, post-operative concurrent chemotherapy for 2 patients and concurrent chemotherapy for one. The Kaplan-Meier method and the Log-rank method were applied to analyze the clinical effects and prognosis. Results The follow-up rate was 96%. The median follow-up was 46 months. The 3- and 5-year overall survival （OS） rates were respectively 89.8% and 77.3%, and the distant failure-free survival （DFFS） rates were respectively 81.8% and 35.9%. The 3- and 5-year locoregional failure-free survival （LRFFS） rates were 79.1% and 56.3%, respectively. Univariate analyses indicated that T-stage, postoperative radiotherapy and surgical margins were correlated with OS （P 〈 0.05）. Surgical margins and postoperative radiotherapy were correlated with LRFFS （P〈 0.05）. The multivariate analysis showed that T-stage was the independent risk factor for OS, and surgical margin was the independent risk factor for LRFFS. Conclusion The recommended treatment for advanced ACC is radical surgery and postoperative radiotherapy.
出处
《肿瘤药学》
CAS
2016年第4期275-280,共6页
Anti-Tumor Pharmacy
关键词
腺样囊性癌
头颈部
放射治疗
预后
Adenoid cystic carcinomas
Head and neck
Radiotherapy
Prognostic factors
