大涎腺恶性肿瘤患者术后放疗的效果及其预后影响因素分析  

Clinical effect of postoperative radiotherapy in patients with major salivary gland tumors and the influence factors of prognosis

作　　者：王文彬[1] 邹佳华[1] 汪井龙 宋建林[1] 

机构地区：[1]黄冈市中医医院肿瘤科,湖北黄冈438000

出　　处：《海南医学》2015年第12期1735-1738,共4页Hainan Medical Journal

基　　金：湖北省自然科学基金(编号:2011CDA023)

摘　　要：目的分析大涎腺恶性肿瘤患者术后实施放疗的临床疗效和影响患者术后生存的相关因素。方法选取我科2002年1月至2009年1月收治的58例大涎腺恶性肿瘤患者,随机分为手术+放疗组(30例)和单纯手术组(28例),比较两组患者术后1年的肿瘤区CT灌注成像情况、术后3、5年的无瘤生存率、总生存率和复发率,采用Log-rank进行单因素检验。结果手术+放疗组术后1年的血流量(BF)、对比血容量(BV)和表面通透性(PS)显著低于单纯手术组,而平均通过时间(MTT)显著多于单纯手术组,差异均具有显著统计学意义(P<0.01);两组患者的术后3、5年的无瘤生存率、总生存率和复发率比较差异均无统计学意义(P>0.05);采用Log-rank检验,T分期、病理类型、手术切除范围和放疗剂量为影响大涎腺肿瘤患者预后的因素(P<0.05)。结论采用手术+术后放疗的方法治疗大涎腺恶性肿瘤疗效优于单纯手术治疗,肿瘤早期、黏液表皮样癌、广泛切除和≥60 Gy的放疗剂量可能是增加生存率的影响因素。Objective To analyze the clinical effect of postoperative radiotherapy in patients with major sali- vary gland tumors and the related factors of postoperative survival. Methods Fifty-eight patients with malignant neo- plasm in major salivary glands in our department from Jan. 2002 to Jan. 2009 were selected and randomly divided into operation combined with radiotherapy group （30 cases） and simple operation group （28 cases）. The patients were compared between the two groups after operation in 1-year CT perfusion imaging of tumor area, 3-, 5-year disease-free survival rate, total survival rate and recurrence rate. Log-rank was used to carry on the single factor test. Results Blood flow （BF）, blood volume （BV） and permeability surface （PS） one year after operation in the operation combined with ra- diotherapy group were significantly lower than that of simple operation group, while the mean transit time （MTT） were significantly more than the simple operation group, and the differences were statistically significant （P〈0.01）. The two groups showed no statistically significant difference in 3-, 5-year disease-free survival rate, total survival rate and recurrence rate （P〉0.05）. Log-rank test showed that T staging, pathological type, operation scope of resection and radiotherapy influenced the prognosis of patients （P〈0.05）. Conclusion Operation combined with postoperative radiotherapy has better curative effect in the treatment of malignant neoplasm in major salivary glands than simple op- eration. Early stage of tumor, radiotherapy dose （≥60 Gy）, mucoepidermoid carcinoma, wide excision might be the factors that increase the survival rate.

关 键 词：大涎腺 肿瘤 术后放疗 预后 影响因素 

分 类 号：R739.8[医药卫生—肿瘤]