手术联合放疗对晚期涎腺腺样囊性癌的疗效探讨

摘要

目的 探讨手术联合放疗对晚期涎腺腺样囊性癌患者的疗效.方法 选取2006年1月至2012年1月四川省人民医院颌面外科收治的晚期涎腺腺样囊性癌52例患者,根据患者术后是否接受放疗将其分为手术联合术后放疗组(S+R组)和单纯手术组(S组),比较两组患者术后总生存率、局部复发率及远处转移率;采用Log-rank 进行单因素检验,探讨各临床病理因素对患者术后复发及远处转移的关系.结果 52例患者随访至2016年12月30日止.中位随访时间为41个月,其中S组3例患者术后远处转移行姑息性化疗,S+R组2例患者失访,未纳入统计;S+R组的术后生存率、5年局部控制率均高于S组,差异均有统计学意义 (P < 0.05);多因素回归分析结果表明,不同的手术方式是远处转移和复发发生的独立影响因素,单纯手术相对于手术联合放疗,更容易发生远处转移和复发.结论 手术联合放疗不能显著提高晚期腺样囊性癌患者的生存率,但相比单纯手术,能减少局部复发和远处转移,提高患者生存效益,值得临床推广.%Objective To investigate the curative effect of surgery combined with postoperative radiotherapy in the treatment of patients with advanced adenoid cystic carcinoma.Methods According to the therapeutic regimen,52 patients with adenoid cystic car-cinoma admitted to the Sichuan Provincial People's Hospital from January 2006 to January 2012 were divided into surgery plus radio-therapy group(S+R group) and simple surgery group(S group).The postoperative total survival rate,local recurrent rate and distinct metastasis rate were compared between the two groups.The Log-rank analysis was used to analyze the relationship between various clini-copathological factors and postoperative recurrence and metastasis.Results All patients were followed up until December 30,2016. The median follow-up time was 41 months.In the S group,three cases with postoperative metastasis underwent palliative chemotherapy. In the S+R group,two cases lost to follow-up.Thus,they were not involved in the statistical analysis.The postoperative survival rate and 5-year local control rate in the S+R group were higher than those in the S group (P < 0.05).Multivariate regression analysis showed that operation method was an independent influence factor for metastasis and recurrence.Compared to the S+R group,the S group had more cases with metastasis and recurrence.Conclusion Compared to surgery alone,surgery combined with radiotherapy can signifi-cantly improve the survival rate of patients with advanced adenoid cystic carcinoma.It can reduce tumor recurrence and metastasis,and improve the survival rate of the patients.Therefore,it is worthy of promotion.