Tükürük bezi kanserli olgularda ameliyat sonrası radyoterapi sonuçlarımız

Amaç: Bu çalışmada ameliyat sonrası radyoterapi RT alan tükürük bezi tümörlü hastalarda tek merkez deneyimimiz değerlendirildi.Hastalar ve Yöntemler: Ocak 1996 - Aralık 2011 tarihleri arasında ameliyat edilen ve adjuvan RT tedavisi için kliniğimize sevk edilen 34 tükürük bezi tümörlü hastanın dosyaları retrospektif olarak incelendi. Primer tümör veya lenfatiklerine 1.8-2 Gy/fraksiyonda medyan 60 Gy 54-70 Gy dozunda RT uygulandı.Bulgular: Medyan izlem süresi 38 aydı dağılım, 3-204 ay . Hastalık en sık 21 hastada %62 parotis bezinde, bunu takiben 11 hastada submandibüler bezde %24 ve iki hastada da minör tükürük bezinde %9 gözlendi. Beş yıllık genel sağkalım GSK %49 dağılım, 3-206 ay ve hastalıksız sağkalım HSK %61 dağılım, 1-173 ay idi. Altı hastada %18 lokal veya bölgesel nüks gelişirken 13 hastada %38 uzak organ metastazı gelişti. Tümör çapının 4 cm’den büyük olması ve RT’ye altı haftadan geç başlanması GSK için sırasıyla, p=0.023, p=0.039 , metastatik lenf nodu varlığı ise HSK için kötü prognostik faktörlerdi p=0.046 . Ekstrakapsüler tutulum varlığı HSK ve GSK’yi anlamlı düzeyde kısaltırken sırasıyla, p=0.022, p=0.050 , genel RT süresinin yalnızca HSK’yi etkilediği gözlendi p=0.046 .Sonuç: Tükürük bezi tümörü nedeniyle ameliyat edilen yüksek riskli hastalarda adjuvan RT’yi önermekteyiz

Our results of postoperative radiation therapy in patients with salivary gland cancer

Objectives: This study aims to evaluate our single center experience in patients with a salivary gland tumor receiving postoperative radiation therapy RT . Patients and Methods: Between January 1996 and December 2011, the records of 34 salivary gland tumor patients who were operated and referred to our clinic for adjuvant RT were retrospectively analyzed. Radiation therapy was applied to the primary tumor and lymphatics at a median dose of 60 Gy 54 to 60 Gy with 1.8-2 Gy/fraction. Results: The median follow-up was 38 months range, 3 to 204 months . The most common site of involvement was the parotid gland in 21 patients 62% , followed by the submandibular gland in 11 patients %24 and minor salivary gland in two patients 9% . Five-year overall survival OS was 49% range, 3 to 206 months and disease free survival DFS was 61% range, 1 to 173 months . Six patients had local or regional recurrences 18% , while 13 patients 38% had distant metastasis. A tumor size larger than 4 cm, over six weeks referral time to RT, and existence of metastatic lymph node were found to be poor prognostic factors for OS p=0.023, p=0.039, respectively , and DFS p=0.046 . While extracapsular involvement significantly reduced the DFS and OS p=0.022, p=0.050, respectively , overall RT time affected DFS alone p=0.046 . Conclusion: We recommend adjuvant RT in high-risk patients operated due to a salivary gland tumor.

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