103例腮腺癌的治疗疗效和预后因素分析

  目的   分析术后辅助治疗对腮腺癌的疗效，探讨腮腺癌的预后因素。   方法   回顾性分析腮腺癌患者103例，分析其生存率、预后因素、比较单纯手术和术后辅助治疗的局控率和无复发生存率、分析各因素与局控率和无复发生存率的相关性。   结果   单纯手术患者和术后辅助治疗患者5年局控率、5年无复发生存率及5年生存率分别为61.90% vs. 81.96%、59.52% vs. 78.69%及68.50% vs. 88.12%（均P < 0.01）。治疗方式、T分期、颈部淋巴结转移及分化程度与5年局控率和5年无复发生存率相关（均P < 0.01）。治疗方式、分化程度、T分期及颈部淋巴结转移与生存相关（均P < 0.01）。   结论   术后辅助治疗能提高腮腺癌的5年局控率、5年无复发生存率及5年生存率；分化程度、T分期及颈部淋巴结转移是腮腺癌预后高危因素。  

Analysis of the therapeutic effect and prognostic factors for carcinoma of parotid gland: a retrospective report of 103 cases

  Objective   This study aims to analyze the therapeutic effect and prognostic factors of carcinoma of parotid gland (CPG).   Methods   Data on 103 CPG patients were retrospectively analyzed. The patients were divided into the simple surgery group (Group One) and post-operative radio-chemotherapy group (Group Two). Kaplan-Meier survival analysis, Log-rank test, and Cox regression analysis were employed to analyze the five-year overall survival. Chi-square test was applied to compare the local control rate and recurrence-free survival. Logistic regression analysis was used to determine the correlation between all factors and the local control rate.   Results   For all patients, the five-year local control rate, five-year recurrence-free survival rate, and five-year overall survival rate were 71.49%, 69.61%, and 76.10% respectively. The five-year local control ratio (81.96% vs. 61.90%), five-year recurrence-free survival (78.69% vs. 59.52%), and five-year overall survival (88.12% vs. 68.50%) were significantly improved in Group Two compared with Group One. The logistic regression analysis showed that the therapeutic method, T staging, as well as pN(+) neck and tumor differentiation were significantly correlated to the five-year local control rate and five-year recurrence-free survival (P < 0.01). Cox regression analysis showed that therapeutic method, T stage, as well as pN(+) neck and tumor differentiation were significantly correlated to the five-year overall survival (P < 0.01).   Conclusion   Post-operative radio-chemotherapy can improve the local control and overall survival rates. This therapeutic method is applicable to patients with T3-4 tumors, as well as pN(+) neck and middle-low differentiation.