腮腺恶性肿瘤术后放射治疗的临床观察

Clinical Observation of Postoperative Radiotherapy with Parotid Gland Tumor Malignant

目的回顾观察腮腺恶性肿瘤术后放射治疗的作用及影响预后的因素。方法40例经病理证实的腮腺恶性肿瘤(I期7例,Ⅱ期19例,Ⅲ期9例,Ⅳ期5例),术后采用60Coγ线和直线加速器电子束或kv级X线进行放射治疗,并随访满3年。结果全组5年生存率66.8%,5年局控率为77.6%。术后放疗以50～60GY剂量组较好,5年生存率为92.7%。病理类型中腺癌、鳞癌较差。手术后30d内放疗最好,5年生存率87.4%。结论腮腺恶性肿瘤应提倡手术加放疗综合治疗。放疗采用光子束和电子束或kv级X线混合射线照射,肿瘤量以50～60GY为宜。手术后应小于30d放疗,可提高生存率。

Objective To observe the role of postoperative radiotherapy for parotid gland tumor malignant and the prognostic factors retrospectively. Methods In 40 postoperated patients with parotid gland tumor malignant（7 in stage Ⅰ , 19 in stage Ⅱ ,9 in stage Ⅲ1,5 in stage Ⅳ ） were radiated by ^60Co γ-rays and linear accelerater E-rays or kv X-rays. All patients were proved by pathology. Follow-up was over three years. Results The 5-years overall survival rates and local controlrates were 66.8% and 77.6% for all patients,respectively. The group given dose 50 - 60Gy had better prognosis and their 5-years overall survived rates were 92.7%. Poor prognosis was observed in the cases with the pathological dissification of adenocarcinoma, squamous cell carcinoma. The 5-years overall survival rates,in 30day and 〉 30day postoperative radiotherapy were 87.4% and 41.8% for patients,respectively. Conclusion It is recommended that treatment for parotid gland tumor malignant should be combined with surgery and radiation. The patients who were given dose 50 - 60Gy mixed with photon-electron beam can get better prognosis. Radical surgical operation and pathological type are the important prognostic factor. In the group 〈 30day of postoperative radiotherapy can get better prognosis.