2016 年第 7 期 第 14 卷

手术切除联合辅助放化疗对腮腺黏液表皮样癌的疗效及患者预后影响因素

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关键词：腮腺黏液表皮样癌放化疗手术切除预后影响因素

• 摘要：
• 【摘要】目的 探讨手术切除联合辅助放化疗对腮腺黏液表皮样癌的疗效及患者预后影响因素。方法 选择2007年1月至2010年1月医院收治的80例腮腺黏液表皮样癌患者，按照治疗方案分为单纯手术组30例和术后联合放化疗组50例，对患者进行为期5年随访，以患者性别、年龄、病程、TMN分期、病理分型、手术类型、治疗方案、淋巴结远处转移等资料作为观察指标，分析患者预后影响因素。结果 单纯手术组5年生存率为63.3%，术后联合放化疗组5年生存率为84.0%，术后联合放化疗组5年生存率显著高于单纯手术组（χ2=4.422,P=0.035）；生存分析显示单纯手术组中位生存期为69.8个月，术后联合放化疗组为90.6个月，两组间比较差异具有统计学意义（χ2=12.039,P=0.001）。单因素分析显示年龄＞60岁、T3～T4分级、低分化程度、单纯手术切除、合并淋巴结远处转移患者5年生存率显著降低（P＜0.05）；多因素分析显示病理分型、治疗方案、淋巴结远处转移是影响患者预后的独立危险因素。结论 术后辅助放化疗能够显著延长腮腺黏液表皮样癌患者的5年生存率，病理分型、治疗方案、淋巴结远处转移是影响患者预后的独立危险因素。
• Objective To explore the clinical efficiency of surgical resection combined with adjuvant radiotherapy and chemotherapy in treatment with parotid mucoepidermoid carcinoma patients and its influencing factors of prognosis .Methods: A total of 80 cases of parotid mucoepidermoid carcinoma patients treated in hospital from January 2007 to January 2010 accorded to the treatment plan were divided into operation group 30 cases and postoperative adjuvant therapy group 50 cases,patients were followed up for 5 years,as gender,age, disease course, TMN stage, pathological classification, operation type, treatment plan, lymph node metastasis and other data as the observation index,the factors affecting the prognosis of patients were analyzed. Results: Operation group 5 years survival rate was 63.3%, postoperative adjuvant therapy group 5 year survival rate was 84.0%,postoperative adjuvant therapy group 5 year survival rate was significantly higher than that in the operation group(χ2=4.422,P=0.035).Survival analysis showed in the operation group median survival was 69.8 months,postoperative adjuvant therapy group was 90.6 months,the difference between the two groups with statistical significance (χ2=12.039,P=0.001).Univariate analysis showed that over 60 years old,T3 ~ T 4 classification,low differentiation, simple surgical resection, and distant metastases in patients with lymph node metastasis 5 year survival rate was significantly lower ( P<0.05),Multivariate analysis showed that pathological classification, treatment plan and lymph node metastasis were the independent risk factors of prognosis.Conclusion: Postoperative adjuvant radiotherapy and chemotherapy can significantly prolong the 5 year survival rate,pathological classification, treatment plan, and lymph node metastasis are independent risk factors affecting the prognosis of patients with parotid mucus.