16例原发腮腺鳞癌的治疗与预后

目的回顾分析16例腮腺鳞癌的临床特点和治疗结果,研究原发腮腺鳞癌预后影响因素及恰当的治疗方案。方法搜集1984-2005年收治并经病理证实的原发腮腺鳞癌16例,其中T1期2例,T2期5例,T3期5例,T4期4例。NO期10例,N＋期6例,单一手段治疗组6例（单纯手术5例,单纯放疗1例）,综合治疗组（手术加放疗）10例。结果全组患者在病程中出现颈部淋巴结转移的概率为75%（12/16）,全组3和5年局部控制率、总生存率、无瘤生存率分别为45%和30%、58%和58%、36%和27%。T1～T2和T3～T4期的5年生存分别为100%和29%,（X^2=4．50,P= 0．034）。NO和N＋期的3年总生存率分别为80%和20%（X^2=8．70,P=0．003）,无瘤生存率分别为54%和0（X^2=9．83,P=0．002）。结论原发腮腺鳞癌颈部淋巴结转移概率和局部复发率均高,应该采用手术加放射的综合治疗;N＋期患者术后应该给予同侧全颈及锁骨上区放疗;手术治疗时未行颈清扫者应行同侧全颈及锁骨上区预防照射。

Treatment and prognosis of primary parotid squamous cell carcinoma:study of 16 patients

Objective To investigate the clinical characteristics and treatment of primary parotid squamous cell carcinoma through 16 patients.Methods Sixteen such patients treated in our hospital from 1984 to 2005 were analyzed retrospectively.There were T1 2 patients,T2 and T3 5 patients each and T4 4. Ten patients had NO,and 6 N+lesions.Six patients were treated by monotherapy,ie-mono group(surgery alone or radiotherapy alone),the other 10 patients by surgery combined with postoperative radiotherapy. Results The overall neck metastastic lymph nodes was observed in 12 patients(75%).The 3- and 5-year local control,overall survival and disease-free survival for the whole group was 45% and 30%,58% and 58%;36% and 27%,respectively.The 5-year survival for T1-T2 and T3-T4 patients was 100% and 29% (X~2=4.50,P=0.034),respectively.The 3-year overall survival of NO and N+patients was 80%,and 20%(X~2=8.70,P=0.003),with a disease-free survival of 54% and 0(X~2=9.83,P=0.002),respec- tively.Conclusions The choice of suitable treatment for locally advanced primary parotid squamous cell carcinoma is surgery plus postoperative radiotherapy.Prophylactic ipsilateral neck irradiation is necessary e- ven for NO patients for the sake of high risk of neck node metastasis.