手术切除联合辅助放化疗对腮腺黏液表皮样癌的疗效及预后影响因素  

Clinical efficacy of surgical resection combined with adjuvant radiochemotherapy in the treatment of mucoepidermoid carcinoma of parotid gland and the prognostic factors

作　　者：李涛[1] 李海涛[1] 李凤梅[1] 郑建金[1] 董刚[1] 刘海蓉[1] 

机构地区：[1]青岛市市立医院口腔科,山东青岛2660110

出　　处：《癌症进展》2016年第7期639-642,共4页Oncology Progress

基　　金：山东省医药卫生科技发展计划项目(2014WS0218)

摘　　要：目的：探讨手术切除联合辅助放化疗对腮腺黏液表皮样癌的疗效及患者预后影响因素。方法选择80例腮腺黏液表皮样癌患者，按照治疗方案分为单纯手术组30例和术后联合放化疗组50例，对患者进行为期5年随访，以患者性别、年龄、病程、TMN分期、病理分型、手术类型、治疗方案、淋巴结远端转移等资料作为观察指标，分析影响患者预后的因素。结果术后联合放化疗组患者5年生存率为84.0%，高于单纯手术组5年生存率为63.3%（χ^2=4.422，P=0.035）；生存分析显示术后联合放化疗组中位生存期为90.6个月高于单纯手术组的69.8个月，差异有统计学意义（χ^2=12.039，P=0.001）。单因素分析显示年龄﹥60岁、T3～T4分级、低分化程度、单纯手术切除、合并淋巴结远端转移患者5年生存率降低（P﹤0.05）；多因素分析显示病理分型、治疗方案、淋巴结远端转移是影响患者预后的独立危险因素。结论术后辅助放化疗能够提高腮腺黏液表皮样癌患者的5年生存率，病理分型、治疗方案、淋巴结远端转移是影响患者预后的独立危险因素。Objective To explore the clinical efficacy of surgical resection combined with postoperative adjuvant ra-diochemotherapy in the treatment for patients with mucoepidermoid carcinoma of the parotid gland and to investigate the relating prognostic factors. Method A total of 80 cases of mucoepidermoid carcinoma of the parotid gland were includ-ed in the study, and were stratified as surgery group （n=30） and surgery＋postoperative adjuvant therapy group （n=50）, patients were followed up for 5 years, and gender, age, disease duration, TMN stage, pathological classification, surgery type, treatment plan, lymph node metastasis and other measures were observed to evaluate the factors influencing the prognosis of patients. Result The 5-year survival rate was 84.0%in surgery＋adjuvant therapy group, and was signifi-cantly higher than that in surgery group at 63.3%（χ^2=4.422, P=0.035）;Survival analysis showed that, the median survival was 90.6 months and 69.8 months in surgery＋adjuvant therapy group and surgery group, respectively, with significant difference observed （χ^2=12.039, P=0.001）. In univariate analysis, it was found that patients with age〉60, classification of T3~T4, poor differentiation, surgical resection alone, and distant metastases in patients with lymph node metastasis had sig-nificantly lower 5-year survival rate （P〈0.05）; While the multivariate analysis showed that pathological classification, treatment plan and lymph node metastasis were the independent risk factors of prognosis. Conclusion Postoperative ad-juvant radiochemotherapy may effectively prolong the 5-year survival for patients with mucoepidermoid carcinoma of pa-rotid gland, and pathological classification, treatment plan, and lymph node metastasis are independent risk factors affect-ing the prognosis.

关 键 词：腮腺 黏液表皮样癌 放化疗 手术切除 预后 影响因素 

分 类 号：R739.87[医药卫生—肿瘤]