北京大学学报(医学版) ›› 2019, Vol. 51 ›› Issue (1): 49-52. doi: 10.19723/j.issn.1671-167X.2019.01.009
Cong LI,Shu-ming LIU,Lei ZHENG,Ming-wei HUANG,Yan SHI,Xiao-ming LV,Jian-guo ZHANG,Jie ZHANG()
摘要:
目的:回顾总结北京大学口腔医院应用手术联合 125I放射性粒子治疗口腔颌面部腺样囊性癌的疗效,并分析相关预后因素。方法:75例原发性口腔颌面部腺样囊性癌患者,行原发灶扩大切除或部分切除,经治疗计划系统(treatment planning system,TPS)制定放射性粒子植入计划,于术中或术后植入放射性粒子,处方剂量60~120 Gy。患者定期随访,采用Kaplan-Meier法评估肿瘤控制及生存情况,并应用Cox回归分析对其相关预后因素进行分析。结果:75例患者3年、5年局部控制率分别为90.0%、78.8%,T1~T2患者分别为92.2%、82.0%,T3~T4患者均为82.6%。无瘤生存率为3年74.9%、5年54.3%。总生存率3年、5年分别为86.0%、79.6%,其中T1~T2患者均为91.3%,T3~T4患者分别为73.9%、59.7%。3年、5年无远处转移生存率分别为84.4%、76.7%,其中T1~T2患者分别为83.4%、79.6%,T3~T4患者分别为86.0%、67.8%。通过COX单因素分析及多因素分析,年龄是影响患者局部控制的预后因素,肿瘤分期及肿瘤部位为影响患者生存率的预后因素。结论: 125I放射性粒子植入作为口腔颌面部腺样囊性癌术后辅助治疗可以获得较好的局部控制率、无瘤生存率及总生存率。高龄者易出现局部复发,肿瘤分期高及肿瘤位于鼻腔、鼻窦者生存率较低。
中图分类号:
[1] |
Kokemueller H, Eckardt A, Brachvogel P , et al. Adenoid cystic carcinoma of the head and neck: a 20 years experience[J]. Int J Oral Maxillofac Surg, 2004,33(1):25-31.
doi: 10.1054/ijom.2003.0448 pmid: 14690656 |
[2] |
Zhang CY, Xia RH, Han J , et al. Adenoid cystic carcinoma of the head and neck: clinicopathologic analysis of 218 cases in a Chinese population[J]. Oral Surg Oral Med Oral Pathol Oral Radiol, 2013,115(3):368-375.
doi: 10.1016/j.oooo.2012.11.018 pmid: 23453028 |
[3] |
Tian Z, Li L, Wang L , et al. Salivary gland neoplasms in oral and maxillofacial regions: a 23-year retrospective study of 6 982 cases in an eastern Chinese population[J]. Int J Oral Maxillofac Surg, 2010,39(3):235-242.
doi: 10.1016/j.ijom.2009.10.016 pmid: 19951834 |
[4] | 于世凤, 高岩 . 口腔组织学与病理学[M]. 北京: 北京大学医学出版社, 2005: 307. |
[5] |
Maciejewski A, Szymczyk C, Wierzgon J . Outcome of surgery for adenoid cystic carcinoma of head and neck region[J]. J Craniomaxillofac Surg, 2002,30(1):59-61.
doi: 10.1054/jcms.2001.0265 pmid: 12064885 |
[6] |
Garden AS, Weber RS, Morrison WH , et al. The influence of positive margins and nerve invasion in adenoid cystic carcinoma of the head and neck treated with surgery and radiation[J]. Int J Radiat Oncol Biol Phys, 1995,32(3):619-626.
doi: 10.1016/0360-3016(95)00122-F pmid: 7790247 |
[7] |
Mendenhall WM, Morris CG, Amdur RJ , et al. Radiotherapy alone or combined with surgery for adenoid cystic carcinoma of the head and neck[J]. Head Neck, 2004,26(2):154-162.
doi: 10.1002/hed.10380 pmid: 14762884 |
[8] |
Huang MW, Zheng L, Liu SM , et al. 125I brachytherapy alone for recurrent or locally advanced adenoid cystic carcinoma of the oral and maxillofacial region [J]. Strahlenther Onkol, 2013,189(6):502-507.
doi: 10.1007/s00066-013-0324-3 |
[9] |
Takagi M, Demizu Y, Hashimoto N , et al. Treatment outcomes of particle radiotherapy using protons or carbon ions as a single-modality therapy for adenoid cystic carcinoma of the head and neck[J]. Radiother Oncol, 2014,113(3):364-370.
doi: 10.1016/j.radonc.2014.11.031 pmid: 25467004 |
[10] |
Chen AM, Bucci MK, Weinberg V , et al. Adenoid cystic carcinoma of the head and neck treated by surgery with or without post-operative radiation therapy: prognostic features of recurrence[J]. Int J Radiat Oncol Biol Phys, 2006,66(1):152-159.
doi: 10.1016/j.ijrobp.2006.04.014 pmid: 16904520 |
[11] |
Al-Mamgani A, van Rooij P, Sewnaik A , et al. Adenoid cystic carcinoma of parotid gland treated with surgery and radiotherapy: long-term outcomes, QoL assessment and review of the literature[J]. Oral Oncol, 2012,48(3):278-283.
doi: 10.1016/j.oraloncology.2011.10.014 pmid: 22093375 |
[12] |
Jensen AD, Nikoghosyan AV, Poulakis M , et al. Combined intensity-modulated radiotherapy plus raster-scanned carbon ion boost for advanced adenoid cystic carcinoma of the head and neck results in superior locoregional control and overall survival[J]. Cancer, 2015,121(17):3001-3009.
doi: 10.1002/cncr.29443 pmid: 26043145 |
[13] |
Casler JD, Conley JJ . Surgical management of adenoid cystic carcinoma in the parotid gland[J]. Otolaryngol Head Neck Surg, 1992,106(4):332-338.
doi: 10.1177/019459989210600403 pmid: 1314372 |
[14] |
Iseli TA, Karnell LH, Preston TW , et al. Facial nerve sacrifice and radiotherapy in parotid adenoid cystic carcinoma[J]. Laryngoscope, 2008,118(10):1781-1786.
doi: 10.1097/MLG.0b013e31817fae29 pmid: 18758382 |
[15] |
Iseli TA, Karnell LH, Graham SM , et al. Role of radiotherapy in adenoid cystic carcinoma of the head and neck[J]. J Laryngol Otol, 2009,123(10):1137-1144.
doi: 10.1017/S0022215109990338 pmid: 19573256 |
[16] |
van Weert S, Bloemena E, van der Waal I , et al. Adenoid cystic carcinoma of the head and neck: a single-center analysis of 105 consecutive cases over a 30-year period[J]. Oral Oncol, 2013,49(8):824-829.
doi: 10.1016/j.oraloncology.2013.05.004 pmid: 23751614 |
[17] |
Zheng L, Zhang JG, Zhang J , et al. Preliminary results of 125I interstitial brachytherapy for locally recurrent parotid gland cancer in previously irradiated patients [J]. Head Neck, 2012,34(10):1445-1449.
doi: 10.1002/hed.21955 |
[18] |
Zheng L, Zhang JG, Song TL , et al. 125I seed implant brachythe-rapy for the treatment of parotid gland cancers in children and adolescents [J]. Strahlenther Onkol, 2013,189(5):401-406.
doi: 10.1007/s00066-013-0313-6 pmid: 23519359 |
[19] |
郭华秋, 刘树铭, 张杰 , 等. 老年头颈癌患者 125I粒子植入治疗后的生存质量研究 [J]. 中华放射医学与防护杂志, 2013,33(5):501-504.
doi: 10.3760/cma.j.issn.0254-5098.2013.05.011 |
[20] |
Lloyd S, Yu JB, Wilson LD , et al. Determinants and patterns of survival in adenoid cystic carcinoma of the head and neck, including an analysis of adjuvant radiation therapy[J]. Am J Clin Oncol, 2011,34(1):76-81.
doi: 10.1097/COC.0b013e3181d26d45 |
[21] | 农晓琳, 陈琦, 黎燕宁 , 等. 63例涎腺腺样囊性癌患者预后相关因素的Cox模型分析[J]. 口腔医学, 2011,31(1):1-4. |
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