腮腺癌术后放疗的评价  

Evaluation of postoperative radiotherapy for parotid gland carcinoma

作　　者：范风云[1] 魏文胜[1] 郭艳[1] 石梅[1] 徐德门[1] 

机构地区：[1]西安第四军医大学西京医院放疗科,710033

出　　处：《实用口腔医学杂志》2004年第6期678-680,共3页Journal of Practical Stomatology

摘　　要：目的 :评价腮腺癌术后放射治疗的价值及影响预后的因素。方法 :86例经病理证实的腮腺癌 (Ⅰ期 7例 ,Ⅱ期 2 8例 ,Ⅲ期 3 3例和Ⅳ期 18例 )术后采用 60Coγ线或直线加速器X线和电子束进行放射治疗 ,并随访 5年以上。结果 :5年生存率 73 .3 % ,5年肿瘤局部控制率 87.2 %。病理类型中未分化癌、鳞癌和恶性多形性腺瘤预后差 ,而腺泡细胞癌和粘液表皮样癌预后较好。临床分期Ⅲ、Ⅳ期预后较差。放疗应在术后 2周开始 ,剂量以 5 1～ 60Gy较好 ,5年生存率为 82 .9%。结论 :腮腺癌应采用手术加放疗的综合治疗 ,放疗应在术后 2周开始 ,肿瘤剂量 5 1～ 60Gy为宜 。Objective: To evaluate the efficacy of postoperative radiotherapy in the treatment of parotid gland carcinoma. Methods: Eighty-six postoperated patients with parotid gland carcinoma( 7 in stage Ⅰ, 28 in stage Ⅱ, 33 in stage Ⅲ and 18 in stage Ⅳ) were radiated by 60Co γ-ray or linear accelerator X-ray combined with electron beam. All patients were diagnosed by pathology and followed up for more than 5 years. Results: The five year survival rate and the local control rate were 73.3% and 87.2% respectively. Poor prognosis was observed in the cases with the neoplastic classification of undifferentiated carcinoma, sequamous cell carcinoma and malignant pleomorphic adenoma, but the better prognosis was obtained in the cases with acinic cell carcinoma and mucoepidermoid carcinoma. Poor prognosis was observed in the cases with stage Ⅲ and Ⅳ of clinical stage. Radiotherapy undertaken in 2 weeks after surgical operation gave higher 5- year survival ratio( 83.8%). The group given 51～60 Gy radiation showed 82.9% of five- year survival rate. Conclusion: The combination of surgery with radiation is effective in the treatment of parotid gland carcinoma.Radiation of 51～60 Gy 2 weeks after operation may result in better prognosis. Neoplastic type and clinical stage are important factors for prognosis.

关 键 词：腮腺癌 放射治疗 预后 

分 类 号：R739.8[医药卫生—肿瘤]