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目的：在１９３９～１９６２ 年间，有４ ２９６ 名年龄小于１６ 岁的儿童因头颈部患良性疾病而接受常规放疗，由此描述良性和恶性唾液腺瘤的剂量与效应关系。方法：选取 ２ ９４５ 名随访资料充分、有唾液腺放疗剂量估算的病人。用放疗记录的有关参数来估算每个病人的剂量，器官剂量用水模和立体数学模型来估算，水模和 ６ 岁拟人模型的剂量非常一致。用 Ｃｏｘ 比例危险回归法分析数据。结果：放疗时腮腺通常处在主射野里，其接受剂量比腭下腺和颌下腺略高，６５９％ 病人腮腺的接受剂量为４５～５．５ Ｇｙ。有８８ 人出现９０ 个唾液腺瘤（其加权平均剂量为 ４２ Ｇｙ），其中 ８０ 个肿瘤发生在腮腺，９ 个在腭下腺，１ 个在颌下腺；６８ 个是良性肿瘤，首例是在照后 １３３ 年出现，８６８％ 是混合多形腺瘤； 恶性唾液腺瘤 ２２ 例，首例在照后 ７ 年出现，４０１％ 是粘液表皮癌。全部唾液腺瘤随剂量而有统计学意义的增加［ Ｐ＝ ０．０２，肿瘤数 ｎ＝ ８９，每 Ｇｙ 剂量的超额相对危险（ Ｅ Ｒ Ｒ／ Ｇｙ）＝ ０．８２］。良性唾液腺瘤（ｎ＝ ６６， Ｅ Ｒ Ｒ／ Ｇｙ＝ １９．６）剂量响应非常明显（ Ｐ＝０．０１））；恶性瘤未见剂量响应关系。结论：上述结果支持良性唾液腺瘤
OBJECTIVE: Between 1939 and 1962, 4,296 children younger than 16 years of age underwent conventional radiotherapy for benign head and neck disease, thus describing the dose-response relationship between benign and malignant salivary adenomas. Methods: A total of 2 945 follow-up patients were selected and patients with salivary gland radiotherapy dose estimation were selected. Each patient’s dose was estimated using radiotherapy-related parameters. The organ dose was estimated using a water model and a three-dimensional mathematical model. The doses of the water model and the 6-year-old personification model were very consistent. Cox proportional hazard regression analysis of the data. Results: The parotid gland was usually located in the main field during radiotherapy. The received dose was slightly higher than that of the palatal gland and submandibular gland. The receiving dose of the parotid gland in 65.9% of patients was 4.5-5.5 Gy. Eighty-eight patients showed 90 salivary adenomas (weighted average dose of 4 2 Gy), of which 80 tumors occurred in the parotid gland, 9 in the palatal gland, and 1 in the submandibular gland. Sixty-eight were benign tumors, 13.3 years after irradiation, 86.8% were mixed pleomorphic adenomas; 22 were malignant salivary adenomas, the first of which occurred 7 years after irradiation and 40.1% of them were mucoepidermoid carcinoma. Total salivary adenoma increased statistically with dose [P = 0.02, number of tumors n = 89, excess relative risk per Gy dose (E R R / Gy) = 0.82]. The dose response was significantly higher in patients with benign salivary adenomas (n = 66, E R R / Gy = 19.6) (P = 0.01). No dose response was seen in malignant tumors. Conclusion: The above results support benign salivary adenoma