中晚期腮腺癌放疗116例分析

RADIATION THERAPY FOR MODERATELY AND ADVANCED PAROTID CANCER—— analysis of 116 cases

从1958年至1986年12月对116例中晚期腮腺癌行放射治疗。病例入组条件是:1.肿瘤体积大、固定或淋巴结固定无法切除;2.肿瘤部分切除;3.术后复发;4.照射剂量>30Gy。照射用220KV—X线、^(60)Co及电子线,射野包括腮腺,有淋巴结转移者,包括同侧颈部淋巴引流区。照射剂量50Gy为宜。手术未切净者应给予足量放疗。全组5、10、15和20年生存率为61.2％,45.4％,43.7％和33.3％。放疗并发症有皮肤溃疡,张口受限及瘢痕增生引起面神经瘫痪。

The authors summarized a group of 116 cases with moderately or advanced parotid cancers treated by radiation therapy from 1958 to 1986. Criteria of patients entry were; a. The tumor being so extensive that surgery was contra-indicated, b. Partially resected tumor, c. Recurrent cancer after operation, and d. Radiation dose ≥30 Gy. Patients lost to follow-up were taken as dead. The 5-, 10-, 15- and 20- year survival rates were 61. 2%, 45. 4%, 43. 7% and 33. 3%. The portal should encompass the whole parotid area and the ipsilateral cervical lymphatics if metastasis is suspected. The dose should be ≥50 Gy. The authors believe that radical radiotherapy is indicated for moderately and advanced parotid cancer, especially for those incompletely resected. To avoid undue skin damage, mixed beam (orthovoltage X-rays, high energy electron beam and supravolt-age X-ray) is preferred. Complications were: skin ulcer, trismus and facial nerve paralysis due to scar contraction.