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目的 :评价腮腺癌术后放疗的价值。方法 :1984～ 1996年本院收治腮腺癌患者 15 8例 ,行单纯手术 5 8例 ,术后放疗 10 0例。治疗后予以再次手术和 /或放疗的分别为前者 4 3例 ,后者 38例。结果 :单纯手术和术后配合放疗 5年生存率 ,分别为 5 6 90 %和 6 8% (P >0 0 5 ) ,腺癌、腺泡细胞癌和恶性混合瘤等恶性度较高者 ,术后放疗可提高 5年生存率 (P <0 0 5 % )。外侵与面神经受累者 ,术后放疗可减少 3年及 5年的复发率 (P <0 0 1) ,而病灶局限且无面神经受累者及颈部淋巴结转移者 ,术后放疗价值不大。单纯手术后复发 ,再次手术并辅以放疗能提高 3年继续生存率并减少 3年再复发率 (P <0 0 5 ) ;而术后放疗后复发 ,再次放疗价值不大 ,反而导致严重的放疗副反应。结论 :病理恶性度较高以及肿瘤外侵或面神经受累者 ,应予以术后放疗 ;术后放疗后复发 ,再次放疗价值不大 ,反而导致严重的放疗副反应。
Objective: To evaluate the value of postoperative radiotherapy for parotid cancer. Methods: From 1984 to 1996, 158 patients with parotid adenocarcinoma were treated in this hospital. 58 patients underwent surgery alone and 10 patients received postoperative radiotherapy. After surgery, reoperation and/or radiotherapy were performed in 43 cases and 38 cases in the latter. RESULTS: The 5-year survival rates of surgery alone and postoperative combined with radiotherapy were 5 6 90% and 6 8% (P > 0 05 ), respectively. Adenocarcinoma, acinar cell carcinoma and malignant mixed tumors were more malignant. Postoperative radiotherapy can improve the 5-year survival rate (P < 0.05%). In patients with extravasation and facial nerve involvement, postoperative radiotherapy can reduce the recurrence rate of 3 years and 5 years (P < 0.01), but the lesions are limited and there is no facial nerve involvement and cervical lymph node metastasis. Postoperative radiotherapy has little value. Recurrence after surgery alone, reoperation and supplemented with radiotherapy can improve the 3-year survival rate and reduce the recurrence rate after 3 years (P < 0.05). However, after recurrence after radiotherapy, the reradiation therapy has little value, but it leads to serious Radiotherapy side effects. Conclusion : Patients with high degree of pathological malignancy and tumor invasion or facial nerve involvement should be treated with postoperative radiotherapy. After recurrence after radiotherapy, the value of reradiation therapy is small, but it leads to serious side effects of radiotherapy.