腭部腺样囊性癌的诊治及预后因素的探讨  

Diagnosis, treatment and prognostic factors of adenoid cystic carcinoma of the palate

作　　者：刘文胜[1] 唐平章[1] 祁永发[1] 高黎[2] 李正江[1] 

机构地区：[1]中国医学科学院中国协和医科大学肿瘤研究所肿瘤医院头颈外科,北京100021 [2]中国医学科学院中国协和医科大学肿瘤研究所肿瘤医院放射治疗科,北京100021

出　　处：《中华肿瘤杂志》2004年第8期485-489,共5页Chinese Journal of Oncology

摘　　要：目的　探讨腭部腺样囊性癌的临床特点、诊断、治疗及预后。方法　回顾分析我院 4 2例腭部腺样囊性癌的临床资料 ,采用Kaplan Meier法和Logrank检验模型进行生存率和预后因素的分析。结果　全组总的 5 ,10 ,15年累积生存率分别为 85 .0 %、6 1.8%和 2 8.1% ,累积无瘤生存率分别为5 2 .4 %、32 .7%和 2 2 .4 % ,累积局部复发率分别为 2 5 .2 %、5 0 .9%和 73.1% ,累积远处转移率分别为2 8.5 %、5 0 .4 %和 6 6 .0 %。病变T分级、骨破坏和软硬腭以外的侵犯与局部复发、远处转移及预后密切相关 ,治疗方式和放射治疗剂量与局部复发和预后也有显著相关性 ,放射治疗范围对预后有明显影响。结论　早期腭部腺样囊性癌可采用单纯手术切除 ,T2期以上病变应采用手术加放射治疗。Objective To explore the clinical characteristics, diagnosis, treatment and prognosis of adenoid cystic carcinoma of the palate. Methods A retrospective review was conducted in 42 patients with adenoid cystic carcinoma of the palate treated in our hospital from 1967 to 1998. Statistical analysis was performed using the Kaplan-Meier method. Prognostic factors were analyzed by Log Rank test. Results The overall 5-, 10-, 15-year accumulative survival rates were 85.0%, 61.8% and 28.1%, and the 5-, 10-, 15-year accumulative disease-free survival rates were 52.4%, 32.7% and 22.4%, respectively. The 5-, 10-, 15-year accumulative local recurrence rates were 25.2%, 50.9% and 73.1%, and the 5-, 10-, 15-year accumulative distant metastasis rates were 28.5%, 50.4% and 66.0% respectively. T stage, bone invasion, extent of tumor, local recurrence and distant metastasis were significant prognostic factors. Treatment method, dose and area covered by radiotherapy were related to the prognosis. Conclusion Surgery alone can be done for early lesions, and combination of surgery with radiotherapy should be adopted for advanced lesions in adenoid cystic carcinoma of the palate. Radiotherapic salvage could prolong the survival of the locally recurrent patients.

关 键 词：腭部 腺样囊性癌 腭肿瘤 放射治疗 手术方式 

分 类 号：R739.8[医药卫生—肿瘤]