手术联合术后放疗治疗涎腺腺泡细胞癌18例临床观察

Clinical investigation of 18 cases of AciCC treated with operation and post-operational radiotherapy

目的探讨手术联合术后放疗治疗涎腺腺泡细胞癌的临床效果。方法回顾性分析2003-2016年新疆医科大学第一附属医院颌面肿瘤外科收住的经手术及术后放疗治疗18涎腺腺泡细胞癌患者的临床资料,定期随访不同时期的复发和转移情况,评价分析手术结合放疗的预后效果。结果 18例患者中,腮腺14例,小唾液腺4例(其中腭部3例,颊部1例)。腮腺患者经浅叶/全叶切除及术后放疗,小涎腺患者经扩大切除及术后放疗。放疗总剂量为46~60Gy。随访时间6~161个月,平均(52.3±36.1)个月。2例分别于术后8a和术后13a失访,最后一次随访结果无局灶及远处复发或转移。16例患者经综合治疗后均无局灶远处复发或转移。18例患者头颈部放疗后照射区无继发恶性肿瘤。结论手术联合术后放疗治疗涎腺腺泡细胞癌效果好。

Objective To investigate the efficacy of surgery and postoperative adjuvant radiotherapy in the treatment of patients with Acinic cell carcinoma （AciCC）. Methods The clinical data of 18 patients with AciCC who underwent surgery and postoperative adjuvant radiotherapy from 2003 to 2016 were retrospec- tively analyzed. The recurrence rate and metastasis rate were observed in different periods. With these rates and clinic data, we can evaluate and analyze the prognosis of surgery combined with radiotherapy. Re- sults Among 18 patients, 14 involved with parotid gland, and 4 involved with minor salivary glands inclu- ding 3 in palatal and 1 in buccal regions. All patients were treated with total/superficial parotidectomy or radical excision. Postoperative adjuvant radiotherapy was used, ranging from 46 to 60 Gy. The mean fol- low-up ranges 6 to 161 months, with average of （52.3＋36.1） months. Two patients were lost after 8 years and 13 years respectively. Loco regional recurrence, distant metastasis and secondary malignance were not observed in all patients. Conclusion Surgery and postoperative adjuvant radiotherapy was shown to be an effective method in the treatment of patients with AciCC.