鼻咽癌放疗原发肿瘤体积变化相关因素分析

[目的]通过分析放射治疗鼻咽癌原发肿瘤体积的变化，寻找影响肿瘤体积变化的相关因素。[方法]分析76例经病理证实的接受根治性放疗的鼻咽癌初治患者年龄、性别、原发肿瘤体积、放疔结束时残留肿瘤体积、放疗6个月后肿瘤体积、原发肿瘤最大截面积、T分期、N分期、病理类型等因素与放疗50Gy时肿瘤退缩率的关系。[结果]多因素相关分析显示随T分期渐晚，肿瘤原发体积增大。肿瘤病理类型中未分化癌原发肿瘤体积最大。腺样囊性癌体积最小，但肿瘤体积退缩率（V50／V0）中高分化鳞癌、腺样囊性癌大，分别为0．68、0．55．显示肿瘤病理类型与近期疗效密切相关（P值为0．000）。体积退缩率与最大截面积退缩率在反应肿瘤近期疗效时密切相关，有很好的一致性。[结论]50Gy时肿瘤退缩率是评价近期疗效的较可靠指标．可部分反映肿瘤放射敏感性。     

鼻咽癌放射治疗后原发肿瘤体积变化的分析

目的观察鼻咽癌放疗后原发肿瘤体积的变化并分析其相关因素。方法回顾性分析46例接受放射治疗的鼻咽癌患者的临床资料,主要包括患者的年龄、性别、病理类型和生长类型、原发肿瘤体积（VO）以及放射治疗结束时残留肿瘤体积（V70）、原发肿瘤最大截面积、T分期和N分期、照射剂量等因素。采用二项分类Logistic回归分析法分析这些因素和放疗50Gy时肿瘤退缩率的关系。结果分析结果显示,肿瘤病理类型和生长类型、T分期、N分期、照射剂量与肿瘤消退有密切关系（P〈0．05）。结论肿瘤体积的变化可较好的反映放疗的效果,明确肿瘤消退的相关因素,可以指导临床治疗,预后判断,提高患者生存率。     

微血管密度和细胞周期调控蛋白B1表达与鼻咽癌放射敏感性的关系

目的:探讨微血管密度、细胞周期蛋白B1与放射治疗前后鼻咽癌肿瘤体积的关系.方法: 对76例病理证实的鼻咽癌患者放疗前鼻咽活检组织进行MVD、CyclinB1免疫组化染色,在50Gy、70Gy、放疗结束后6个月行增强CT扫描,计算肿瘤体积,用SPSS10.0统计软件进行Spearman等级相关分析及偏相关分析.结果: ClydinB1表达与V50/V0,V70,V6m的关系:与V50/V0 P=0.036;与V70 P=0.199;与V6m P=0.142.MVD表达与V50/V0,V70,V6m的关系:与V50/V0 P=0.036;与V70 P=0.199;与V6m P=0.142.ClydinB1表达与MVD关系:P=0.000.结论:微血管的生成是鼻咽癌生长的关键,它的高低与临床放射敏感性密切相关.CyclinB1与临床放射敏感性指标V50/V0(肿瘤退缩率) 密切相关.ClydinB1与MVD密切相关.     

微血管密度和细胞周期调控蛋白B1表达与鼻咽癌放射敏感性的关系

目的：探讨微血管密度、细胞周期蛋白B1与放射治疗前后鼻咽癌肿瘤体积的关系。方法：对76例病理证实的鼻咽癌患者放疗前鼻咽活检组织进行MVD、CyclinB1免疫组化染色,在50Gy、70Gy、放疗结束后6个月行增强CT扫描,计算肿瘤体积,用SPSS10.0统计软件进行Spearman等级相关分析及偏相关分析。结果：ClydinB1表达与V50/V0,V70,V6m的关系：与V50/V0P=0.036;与V70P=0.199;与V6mP=0.142。MVD表达与V50/V0,V70,V6m的关系：与V50/V0P=0.036;与V70P=0.199;与V6mP=0.142。ClydinB1表达与MVD关系：P=0.000。结论：微血管的生成是鼻咽癌生长的关键,它的高低与临床放射敏感性密切相关。CyclinB1与临床放射敏感性指标V50/V0（肿瘤退缩率）密切相关。ClydinB1与MVD密切相关。     

鼻咽癌常规放疗中肿瘤退缩速度对预后的影响

目的探讨鼻咽癌患者放疗过程中肿瘤退缩速度与预后的关系。方法接受根治性放疗的753例鼻咽癌患者,原发肿瘤和转移淋巴结的体外照射处方剂量为65～70Gy,颈部预防剂量50～55Gy。≤50Gy完全退缩的定义为快速退缩,>50Gy～≤70Gy完全退缩的定义为缓慢退缩,其余的定义为残留。采用KaplanMeier法进行生存分析,差异用Logrank检验,对可能影响预后的因素运用Cox回归模型分析。结果快速退缩、缓慢退缩、残留的5年生存率分别为64.6%、72.5%和49.7%(χ2=8.92,P=0.004),无病生存率分别为60.2%、71.8%和29.4%(χ2=9.75,P=0.002),无远地转移生存率分别为70.8%、80.3%和55.1%(χ2=10.36,P=0.001),无局部区域失败生存率分别为88.0%、88.4%和65.9%(χ2=9.81,P=0.001)。多因素分析发现肿瘤退缩速度、T分期、N分期对预后有明显影响,而性别与年龄不是预后相关因素。结论根治性放疗过程中肿瘤退缩速度明显影响鼻咽癌患者的5年生存率、无病生存率、无远地转移生存率、无局部区域失败生存率。缓慢退缩的预后最好,快速退缩的其次,残留的最差。     

鼻咽癌原发灶消退率与预后的关系

目的 探讨鼻咽癌原发灶消退率与远期疗效的关系.方法 行常规放疗的无远处转移初治鼻咽癌患者90例,放疗前及放疗中(36 ～40 Gy)均有鼻咽部增强CT,利用PACS中的多边形工具勾画鼻咽原发灶,采用面积求和法分别计算出放疗前及放疗中鼻咽癌原发灶肿瘤体积,以肿瘤体积消退百分率R[(放疗前体积V0-放疗中体积V36)/放疗前体积V.×100％]代表原发灶消退率.结果 全组TG患者4年局部控制率(LCR)、无远处转移生存率(DMrS)、无瘤生存率(DFS)、总生存率(0S)分别为:90.3％、81.2％、71.5％、81.6％.按鼻咽癌原发灶消退率分3组:低度敏感组(LSG,消退率＜50％)27例,中度敏感组(MSG,消退率≥50％,＜80％)29例,高度敏感组(HSG,消退率≥80％)34例,LSG、MSG、HSG组患者4年局部控制率(LCR)、无远处转移生存率(DMFS)、无瘤生存率(DFS)、总生存率(0S)分别为:84.1％、78.6％、63.4％、82.2％,97.5％、83.3％、79.4％、86.6％和90.4％、82.2％、71.5％、77.6％,P值均＞0.05.结论 本组资料提示中等消退率鼻咽癌患者预后略好于消退快及消退缓慢者,但仍不能证明鼻咽癌原发灶消退率与远期疗效之间存在必然联系.     

三维计划系统体积定量方法对鼻咽癌放射敏感性的动态观察

目的利用三维治疗计划系统体积定量法动态观察分析鼻咽癌的放射敏感性及其影响因素.方法43例经病理证实的鼻咽癌病例,男女之比为2.58:1;中位年龄54岁;低分化鳞癌40例,低分化癌3例.全部采用常规外照射放射治疗,放射源为加速器6 MV X线.分别在放疗前、放疗15次(30 GY)及放疗30～35次(65 GY)时在CT模拟定位机上做CT增强扫描,利用放射治疗计划系统计算肿瘤体积,观察其放射敏感性.结果原发灶 颈部淋巴结的总体积退缩率与原发灶体积的退缩率呈正相关(相关系数0.932,P=0.000);原发灶体积与肿瘤T分期正相关(P=0.003);临床检查所观察到的缩小速度与总体积退缩率的相关系数为0.112(P=0.398);未发现血液血红蛋白水平与总体积退缩率的相关性.结论利用三维治疗计划系统体积定量法来测定鼻咽癌的放射敏感性是一种简便可行的方法.     

基于临床经验的局部晚期鼻咽癌互补分野加量照射的改进方案

目的探讨颅底、后颅窝和茎突后区广泛C形侵犯局部晚期鼻咽癌互补分野同期加量照射(SF-SBI)分割剂量的合理设置、设野的优化和应用时机。方法选取2004年1月至2008年6月中山大学肿瘤防治中心收治的局部晚期NPC患者6例,分别采用分割剂量为2.3~2.7Gy/次的不同SF-SBI方案,用剂量体积直方图比较加量照射肿瘤靶区(BTV)、原发肿瘤计划靶体积(PTVnx)和危及器官(OARs)的剂量学特点差异,评价其临床疗效及并发症。结果全组BTV的平均剂量(Dmean)为73.8~76.2Gy,95%处方剂量所包含的靶体积百分数(V95%)为95.8%~99.9%。PTVnx的Dmean为70.3~75.9Gy,V95%为96.0%~99.9%。靶区中不存在大于80Gy的体积。PTV1和PTV2的V95%分别为98.8%~99.9%和98.9%~99.9%。脑干的50、60Gy所包含的体积百分数(V50、V60)和33%体积所受照射的最大剂量(D33)分别为13.2%~46.3%、2.6%~12.8%和23.8~53.9Gy。同侧颞叶的Dmean、D33和V60分别为23.8~32.2Gy、26.4~39.2Gy和19.5%~25.7%。患者A、B、C同侧颞叶的百分体积分别为9.5%、32.2%和28.7%。同侧颞颌关节的Dmean和D50分别为69.1~76.2Gy和62.2~69.8Gy。随访时间3.5~7年。除患者A为部分缓解(PR)外,其余患者均在放疗中或放疗后获得完全缓解(CR),所有患者均未出现肿瘤局部进展或复发。无1例患者出现脑干放射损伤。采用较大分割剂量(2.4~2.7Gy/次)的患者分别出现了放射性脑病、后组脑神经损伤和严重的张口困难。结论从放疗开始即对BTV和大部分GTV采用2.3Gy/次分割剂量进行照射改进的SF-SBI适形放射治疗计划,以及根据肿瘤实际退缩情况个体化缩小后程放疗射野的优化理论,为局部晚期NPC实施个体化放疗提供了新的技术参考。     

鼻咽癌颈淋巴结放疗敏感性的多元Logistic回归分析

目的分析多药耐药相关蛋白(multidrug resistance-associated protein,MRP)在鼻咽癌中的表达以及N分期、病理分化程度与鼻咽癌颈淋巴结放疗敏感性关系,探讨多因素对肿瘤放疗敏感性的影响.方法采用免疫组化S-P法检测鼻咽癌组织中MRP的表达,采用多元Logistic回归分析法,分析MRP的表达、N分期、病理分化程度与鼻咽癌颈淋巴结放疗敏感性的关系.结果鼻咽癌中MRP阳性表达率为66.7%(30/45).N1分期放疗敏感性高于其他N分期(N2-3),差异有显著性(P<0.05),但复查CT时差异无显著性(P>0.05),其他N分期(N2-3)之间差异无显著性(P>0.05);MRP阳性表达者,在DT 50 Gy时临床肿瘤完全缓解率和放疗结束时复查CT的肿瘤残存率,与阴性表达之间差异无显著性(P>0.05),但在放疗结束时临床肿瘤残存率,与阴性表达之间差异有显著性(P<0.05);低分化鳞癌和中分化鳞癌颈淋巴结放疗敏感性差异无显著性(P>0.05).结论鼻咽癌组织中有较高水平的MRP表达.在鼻咽癌颈淋巴结放疗敏感性的预测上,N分期和MRP的表达有一定的指导意义,病理分化程度则无明显临床指导意义.     

靶向治疗Ⅳ期非小细胞肺癌体积变化及放疗时机选择研究

目的 探讨驱动基因敏感突变Ⅳ期非小细胞肺癌分子靶向治疗后肿瘤体积变化规律及开始放疗时机。方法 采用前瞻性研究方法通过模拟定位CT结果分析治疗前后每隔10d原发肿瘤体积变化。当前后两次体积变化≤5%或治疗90天后终止定位和体积测量并实施放疗,记录放疗急性不良反应,比较实施和模拟放疗计划的相关参数。结果 30例中 29例纳入分析(1例脱落),人表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKI)治疗后原发肿瘤体积均缩小,但退缩率和速度不一致,至终止定位时最大缩小90%、最小缩小28%;治疗40d内平均体积缩小明显,每间隔10d的平均体积不同(P<0.001);40天后逐渐出现因原发肿瘤体积退缩率≤5%的病例,至90天仅 1例体积退缩>5%,平均体积退缩速度减慢而趋于稳定,退缩率为 49.15%~54.77%;70天平均体积略有增大后又缓慢缩小,每间隔10d的平均体积相近(P>0.05)。终止定位后实施放疗病例的原发肿瘤可给予剂量为(69±7) Gy,发生2、3级急性放射性肺炎和放射性食管炎分别为 2例和 3例、1例和 0例。按照实施放疗计划的技术、剂量参数分别设计EFGR-TKI治疗前和第40天的模拟放疗计划,全部显示实施计划显著优于EGFR-TKI治疗前模拟计划(P均<0.05),而与第40天模拟放疗计划之间相近(P>0.05)。结论 EGFR-TKIs治疗后Ⅳ期非小细胞肺癌的原发肿瘤退缩率随时间推移逐渐减缓,40天内缩小最显著而后缓慢缩小,每一病例的肿瘤退缩速度不一致,治疗后40天开始放疗可能是获得提高剂量并控制放射损伤的最佳时机。     

眼部结构侵犯的鼻腔鼻窦腺样囊性癌疗效及治疗策略探讨

背景与目的：鼻腔鼻窦腺样囊性癌是一种少见的头颈部肿瘤,由于该肿瘤的高侵袭性和沿着神经浸润生长的习性,以及鼻腔鼻窦与眼部紧邻的解剖特征,部分患者初诊时即有眼部结构的侵犯,从而造成治疗的困难。该研究总结了伴有眼部结构侵犯的鼻腔鼻窦腺样囊性癌患者的临床资料及预后情况,探讨该类疾病的疗效及治疗策略。方法：该研究为一项单中心、回顾性的研究,分析了138例2005年1月—2017年10月在复旦大学附属眼耳鼻喉科医院接受过放疗的鼻腔鼻窦腺样囊性癌患者。采用Kaplan–Meier方法对主要终点总生存期进行估计,组间比较总生存期采用时序检验,并适时进行Cox比例风险回归分析;分类变量组间比较采用Pearson χ2检验。结果：男性74例（53.6%）,女性64例（46.4%）。平均年龄（51.0±11.6）岁。鼻腔为最常见的原发部位,共97例（70.3%）。临床分期以Ⅲ~Ⅳ期为主,共97例（70.2%）。术前放疗为24例（17.4%）,术后放疗为86例（62.3%）,单纯放疗为28例（20.3%）。放疗的平均剂量为（64.8±4.5）Gy。有眼部侵犯者为54例（39.1%）,无眼部侵犯者为84例（60.9%）。有眼部侵犯的患者在治疗中保留眼球者为40例（89.9%）,行眶内容物剜除者为14例（10.1%）。54例有眼部侵犯的患者中,术前放疗16例（29.6%）,术后放疗24例（44.4%）,单纯放疗14例（25.9%）。54例有眼部侵犯的患者的1、3、5和11年的总生存率（overall survival,OS）分别为94.4%、81.3%、71.4%和66.6%。84例无眼部侵犯的患者的1、3、5和11年的OS分别为98.8%、95.6%、93.9%和75.4%。早期患者（T₁期+T₂期）的OS明显优于T₃、T_4a及T_4b期的中晚期患者。无眼部侵犯的鼻腔鼻窦腺样囊性癌患者的疗效明显优于有眼部侵犯的患者（P=0.016）。保留眼球组生存优于眶内容物剜除组（P=0.002）。对于有眼部侵犯的患者而言术前放疗可能会取得更好的疗效（与术后放疗比较：P=0.081,与单纯放疗比较,P=0.096）,值得进一步探讨。结论：鼻腔鼻窦腺样囊性癌疗效与T分期明显相关。有眼部侵犯的鼻腔鼻窦腺样囊性癌患者疗效较差,术前放疗可能有助于提高该类患者的生存率。     

Better prediction of prognosis for patients with nasopharyngeal carcinoma using primary tumor volume

BACKGROUND: Heterogeneity of primary tumor volume within tumors of the same classification indicates a need to elucidate the effects of primary tumor volume on treatment outcomes in patients with nasopharyngeal carcinoma (NPC). METHODS: From 1994 through 1996, 129 patients with newly diagnosed NPC who were treated with high-dose radiotherapy were enrolled in the study. Computed tomography-derived primary tumor volume was measured using the summation-of-area technique. Correlations between American Joint Committee on Cancer (AJCC) disease stage, primary tumor volume, and disease-specific survival were assessed using a Cox regression model. Cross-validation based on receiver operating characteristic (ROC) curve also was examined. RESULTS: Compared with the AJCC staging system and the TNM classification system, primary tumor volume was better at determining cumulative survival for patients with NPC. Hazard ratios increased with tumor volume, ranging from 6.68 (95% confidence interval [95% CI], 1.89-23.67) for tumor volumes between 20-40 mL, 18.03 (95% CI, 4.80-67.75) for tumor volumes between 40-60 mL, and 26.06 (95% CI, 7.70-88.20) for tumor volumes > 60 mL. With both tumor volume and T classification in the same Cox regression model, only tumor volume remained statistically significant in the prognosis of NPC. The validation results with ROC curves also revealed that, in predicting patient outcome, primary tumor volume (area under the ROC = 83.33%) was superior to disease stage (area under the ROC = 66.53%) and TNM classification (area under the ROC = 58.61%). CONCLUSIONS: The incorporation of primary tumor volume may lead to a further refinement of the current AJCC staging system, particularly for patients with large primary tumor volumes (> 60 mL), who require more aggressive treatment. Cancer 2004.     

Maxillary sinus carcinomas: natural history and results of postoperative radiotherapy

Between 1969 and 1985, 73 patients with maxillary sinus cancers underwent surgical excision and postoperative radiotherapy. The clinical stage distribution by the AJC system was 3T1, 16T2, 32T3, and 22T4. Six patients had palpable lymphadenopathy at diagnosis. Surgery for the primary tumor consisted of partial or radical maxillectomy, and if disease stage indicated it, ipsilateral orbital exenteration. This was followed by radiation treatment delivered through a wedge-pair or three-field technique. All but three patients received 50-60 Gy in 2 Gy fractions to an isodose line defining the target volume. Elective neck irradiation was not routinely given. Clinically involved nodes were treated with definitive radiotherapy (five patients) or combined treatment (one patient). Forty-five patients had no evidence of disease at the last follow-up. The 5-year relapse-free survival for the whole group was 51% The overall local control rate was 78%. Patients with larger tumors, particularly if they also had histological signs of nerve invasion, had a higher recurrence rate than others. The overall nodal recurrence rate without elective neck treatment was 38% for squamous and undifferentiated carcinoma, and only 5% for adenoid cystic carcinomas. Therefore, our current recommendation is to deliver elective nodal irradiation routinely to patients with squamous or undifferentiated carcinoma, except for those who have T1 lesions. Treatment complications were vision impairment, brain and bone necrosis, trismus, hearing loss, and pituitary insufficiency. The incidence of major side effects was determined by disease extent and treatment technique. Many technical refinements were introduced in order to limit the dose to normal tissues in an attempt to reduce the complication rate.(ABSTRACT TRUNCATED AT 250 WORDS)     

Successful primary radiation therapy of adenoid cystic carcinoma of the lung

Adenoid cystic carcinoma is a distinctive malignant neoplasm generally arising from minor salivary glands, that arises infrequently as a primary tumor in the lung. Surgery has been considered the primary treatment, with radiotherapy generally utilized as adjuvant or palliative treatment. We report a patient in whom primary radiotherapy was sucessfully applied to treat adenoid cystic carcinoma involving the distal trachea, carina, and both main stem bronchi. A total dose of 66 Gy was delivered in 2-Gy fractions over a 7-week period. Clinically and histologically complete remission was achieved without evidence of disease during a 27-month follow up.     

Adenoid cystic carcinoma of the uterine cervix

Adenoid cystic carcinoma of the uterine cervix is a rare and peculiar variant of adenocarcinoma. This tumor represents 3% of all primary cervical adenocarcinomas, and it is locally aggressive and capable of metastasis to other organs even in its early stage. We report a case of adenoid cystic carcinoma stage IIIb that was successfully treated with radiotherapy. The patient shows no evidence of recurrent tumor at 5 years after radiotherapy. Generally, radiotherapy and chemotherapy are chosen as the first treatment, because this cancer is seen most commonly in the elderly.     

Primary Adenoid Cystic Carcinoma of the Skin with Multiple Local Recurrences

Primary adenoid cystic carcinoma (PACC) of the skin is a rare tumor with fewer than 70 cases studied in detail in the English literature. This type of tumor shows a prolonged course and a growth pattern usually manifested by multiple local recurrences and has a low potential for distant metastases. The most important modality for primary treatment is surgical resection followed by radiotherapy. We report a woman aged 43 years at the time of diagnosis, who presented with a slow-growing nodule in the right axilla without lymph node enlargement. A wide local excision was performed, and the histology revealed an adenoid cystic carcinoma. During the next 24 years, another four local recurrences were excised (the last one in 2015) and confirmed histologically to be adenoid cystic carcinoma. The patient was given 44 Gy of radiotherapy after the second surgery in 1996. PACC of the skin is a rare tumor with insufficient data concerning the efficacy of the surgical technique and chemotherapy and radiotherapy treatment, even more so in the case of multiple recurrences. After the last recurrence, the patient was offered an active follow-up based on the long tumor-free intervals in the past and because the site of the primary tumor allowed further surgical excisions in future recurrences.Key Words: Adenoid cystic carcinoma, Cylindroma, Skin     

305例鼻咽癌调强放疗预后因素分析

背景与目的:放疗是鼻咽癌治疗的有效手段。本研究目的是分析大样本量调强放疗(intensity-modulated radiation therapy,IMRT)治疗鼻咽癌的效果、不良反应并探索其预后因素。方法:分析从2003年9月到2006年9月在福建省肿瘤医院接受IMRT的305例鼻咽癌患者临床资料并作生存分析。肿瘤靶区的处方剂量为66～69.75Gy/30～33次。Ⅲ～Ⅳa期患者接受了以铂类为基础的化疗。结果:中位随访时间35个月(5～61个月)。分别有16、8和39例出现局部﹑颈部淋巴结复发及远处转移。3年局控率﹑区域淋巴结控制率﹑无远处转移率﹑无瘤生存率及总生存率分别为94.3%﹑97.7%﹑86.1%﹑80.3%和89.1%。多因素分析表明T分期并不影响局控率及总生存率(P>0.05),N分期是影响总生存率(P=0.000)、无远处转移率(P=0.000)及无瘤生存率(P=0.003)的独立预后因素。同步和辅助化疗不改善Ⅲ～Ⅳa期患者预后(P>0.05)。严重的急性不良反应包括Ⅲ度皮肤反应14例(4.6%)、Ⅲ度口腔黏膜反应90例(29.5%)及Ⅲ～Ⅳ度骨髓抑制20例(6.5%);IMRT治疗两年后...     

64例大涎腺腺样囊性癌的预后因素分析

背景与目的:涎腺腺样囊性癌是一类恶性程度高的涎腺肿瘤,针对大涎腺来源的腺样囊性癌的研究较少。本研究旨在探讨影响大涎腺腺样囊性癌患者预后的因素。方法:回顾性分析1971年1月至1998年7月中山大学肿瘤防治中心收治并随诊7年以上的64例大涎腺腺样囊性癌患者的临床资料,应用Kaplan-Meier法进行生存分析,组间比较用log-rank检验,多因素分析采用Cox模型进行分析,两组比率的比较采用χ2检验。结果:本组总死亡率为57.8%,肿瘤相关死亡率为46.9%;5年、10年累积生存率分别为65.6%和54.5%;复发率为34.4%,远处转移率为45.0%;单因素分析结果显示,年龄、神经是否受侵、病理类型、临床分期、手术切缘是否干净是影响患者预后的因素。年龄≥50岁、神经受侵、病理类型为实体型或小管型、临床分期为晚期(Ⅲ、Ⅳ期)、切缘阳性者的预后较年龄<50岁、神经未受侵、病理类型为筛孔状、临床分期为早期(Ⅰ、Ⅱ期)、切缘阴性者差;多因素分析结果显示,神经受侵、病理类型为实体型、临床分期属于晚期(Ⅲ、Ⅳ期)、切缘阳性者,预后差。结论:神经是否受侵、病理类型、临床分期、手术切缘是否干净是影响大涎腺腺样囊性癌患者预后的独立因素。     

Adenoid cystic carcinoma of the lung: Response to tamoxifen after chemoradiation

Primary adenoid cystic carcinoma of the lung is a rare subtype of lung cancer with a prolonged natural history but is difficult to completely resect surgically due to its proximal location. Hence radiotherapy plays a role for local control of these cancers. The role of systemic therapies in the treatment of adenoid cystic carcinoma of the lung remains unclear. Isolated case reports have previously described the treatment of primary adenoid cystic carcinoma of the lung with tamoxifen, resulting in partial control. We report the first case of primary adenoid cystic carcinoma of the lung treated with primary chemoradiotherapy due to unresectable location of the tumor, and disease stabilization with symptomatic response to tamoxifen following tumor recurrence. There is a need for further studies to investigate the role of anti‐hormonal therapies in the treatment of adenoid cystic carcinoma of the lung.