【摘要】 目的:探讨唾液腺癌经手术联合125I粒子治疗后远处转移的一般规律及影响远处转移的临床病理因素。方法:选取2001年10月至2010年3月就诊于北京大学口腔医院经手术联合125I粒子治疗的唾液腺癌患者197例,总结远处转移的发生特点,应用单因素和多因素方法分析影响远处转移的临床病理因素。结果:远处转移率为14.2%(28/197),常见部位是肺(25/28,89.3%),其次是骨(5/28,17.9%)和肝(4/28,14.3%);诊断至远处转移的时间为5~168个月,平均时间(44.2±45.8)个月,中位时间64个月;远处转移至死亡的时间为0~54个月,平均时间(9.7±13.4)个月,中位时间12个月。3年局部区域控制率和生存率分别为90.8%,87.8%;5年分别为84.0%,81.0%。单因素分析局部区域控制情况(F=26.997,P<0.01)和组织学分型(F=1.592,P<0.01)是唾液腺癌远处转移的危险因素;而性别、年龄、原发部位、T分期、术后淋巴结是否阳性、肿瘤切缘及面神经侵犯情况,与唾液腺癌远处转移无显著关系;多因素分析局部区域控制情况(F=29.332,P<0.01)是影响唾液腺癌远处转移的主要因素。结论:手术联合125I粒子治疗唾液腺癌,局部控制率高,延长远处转移的发生时间,局部区域控制情况是影响唾液腺癌远处转移的主要因素。更多还原

【Abstract】 Objective: To investigate clinical features of distant metastases( DM) and analyze clinicopathologic risk factors associated with DM from salivary gland carcinomas after being treated by surgery combined with125 I internal brachytherapy. Methods: Between October 2001 and March 2010,197 patients with salivary gland carcinoma were treated by surgery combined with125 I internal brachytherapy and had follow-up for 2 years or more. Univariate and multivariate analyses were performed to evaluate clinicopathologic risk factors that might influence the risk of distant metastases. Results: DM occurred in 28 of197 patients( 14. 2%). The commonest site of distant metastases overall was the lung 89. 3%( 25 /28),followed by bones 17. 9%( 5 /28) and liver( 4 /28). DM developed after an average interval of( 44. 2 ±45. 8) months from the time of initial diagnosis,and the mean interval was 64 months. The average time to death after the diagnosis of DM was only( 9. 7 ± 13. 4) months,and the mean time was 12 months.The 3-year locoregional control rate and survival rate were 90. 8%,and 87. 8% respectively,and the 5-year ones 84. 0% and 81. 0%,respectively. Univariate analyses revealed that the risk of distant metastases was significantly influenced by locoregional tumor failure( F = 26. 997,P < 0. 01) and histologic differentiation( F = 1. 592,P < 0. 01). Multivariate analysis of freedom from distant metastases revealed that locoregional control( F = 29. 332,P < 0. 01) significantly influenced this end point. Conclusion: Salivary gland carcinoma could achieve high local control rate after being treated by surgery combined with125 I internal brachytherapy,and the average interval from diagnosis to DM was prolonged,DM was significantly influenced bylocoregional control.更多还原