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題名 | Postoperative Adjuvant Radiotherapy for Adenoid Cystic Carcinoma of the Head and Neck: Treatment Results and Prognostic Factors=頭頸部腺樣囊狀腫瘤病人接受術後放射線治療之治療結果與預後因子 |
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作者 | 許軒之; 黃英彥; 王重榮; Hsu, Hsuan-chih; Huang, Eng-yen; Wang, Chong-jong; |
期刊 | 長庚醫學 |
出版日期 | 20030900 |
卷期 | 26:9 2003.09[民92.09] |
頁次 | 頁646-653 |
分類號 | 416.21 |
語文 | eng |
關鍵詞 | 頭頸部腺樣囊狀腫瘤; 手術後放射線治療; 預後因子; Adenoid cystic carcinoma; Postoperative radiotherapy; Prognostic factors; |
中文摘要 | 背景:分析頭頸部腺樣囊狀腫瘤病人接受術後放射線治療之治療結果與預後因子。 方法:從1987年10月至1999年12月共25位接受根除性手術的頭頸部腺樣囊狀腫瘤病人前來本科托受術後放射線輔助治療,總劑量為44-68.4格雷,每位病人均無接受化學治療且至少有2年的追蹤。 結果:此25位病人之5年存活率、局部控制率及無遠處轉移率分別為75%、83%及66%。至今有兩位病患復發於原發部位,1位發生局部淋巴結轉移;共7位(28%)病患有遠處轉移病灶,且此7位遠處轉移病患中有6位(86%)其原發部位均無局部復發,肺部為最好發之遠處轉移器官。以多變數分析,本研究發現疾病期別為無遠處轉移率統計上最有意義之預後因子(p=0.009)。 結論:病人為較晚期整疾病期別(第三、四期)即使給予術後放射線治療仍有較高之遠處轉移率,遠處轉移仍然為治療頭頸部腺樣囊狀腫瘤之主要問題,然而此問題目前仍無解決之道。 |
英文摘要 | Background: To analyze the treatment results and prognostic factors of patients with adnoid cystic carcinoma (ACC) arising form the major and minor salivary glands of the head and neck, and who received postoperative radiotheraphy after radical tumor resection. Methods: Between October 1987 and December 1999, 25 patients with ACC of the head and neck were treated with radical surgical resection and postoperative adjuvant irradiation without chemotherapy. Using appropriate radiation techniques to the tumor bed, total doses ranged from 44 68.8 Gy. All patients had a minimum of 2 years of follow-up. Results: The 5-year overall survival rate, local control rate, and distant metastasis-free rate were 75%, 83%, and 66%, respectively. To the present, 2 patients had experienced recurrence at the primary sites, and 1 had regional lymph node metastasis. Distant metastases developed in 7 patients (28%), of whom 6 (86%) were disease-free at eh primary site. The lung was the most common distant metastasis site. In multivariate analysis, the only statistically significant prognostic factor for a distant metastasis-free rate was the stage at presentation(p=0.009). Conclusion: Patients with an advanced stage of disease had higher distant metastasis rates even when receiving postoperative reaiotherapy. Distant metastasis is still the main problem in the management of ACC of the head and neck. However, more-effective treatment for this problem is still lacking. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。