中国耳鼻咽喉头颈外科2025，Vol.32Issue(5)：273-278,6.DOI:10.16066/j.1672-7002.2025.05.001
336例头颈部腺样囊性癌术后放疗剂量与预后相关分析
Association between postoperative radiotherapy dose and prognosis in head and neck adenoid cystic carcinoma:A retrospective analysis of 336 cases
摘要
Abstract
OBJECTIVE To evaluate the clinical value of dose-escalated postoperative radiotherapy(PORT)in improving local control and survival outcomes for head and neck adenoid cystic carcinoma(ACC)patients.METHODS This retrospective study analyzed 336 ACC patients treated with surgery plus PORT at Beijing Tongren Hospital from January 2015 to January 2021.Cohort stratification compared high-dose(>60 Gy,n=146)and conventional-dose(≤60 Gy,n=190)regimens.Survival analysis employed Kaplan-Meier estimates with log-rank testing,complemented by multivariate Cox regression for risk adjustment.RESULTS The cohort demonstrated 39.29%(132/336)cumulative local failure rate.The overall survival rates at 1,3,and 5 years after surgery were 98.81%,94.05%,and 90.48%,respectively.Dose-response relationships revealed:1.Significantly reduced local recurrence with high-dose PORT(28.08%vs.47.89%,P<0.001),corresponding to 41.37%lower recurrence risk(a HR=0.59,95%CI=0.38-0.91;P=0.041);2.Superior progression-free survival in the high-dose group(3-year:86.99%vs.76.32%;5-year:82.19%vs.66.32%,all P<0.05);3.Comparable overall survival between groups(median OS:200 vs.160 months,P=0.292).CONCLUSION Dose escalation beyond 60 Gy significantly enhances locoregional control and progression-free survival in head and neck ACC without conferring overall survival advantage,likely reflecting the disease's characteristic indolent metastatic progression.These results establish>60 Gy as an optimal dose threshold for PORT in high-risk ACC management.关键词
头颈部肿瘤/癌,腺样囊性/放射治疗剂量/局部复发/生存分析Key words
Head and Neck Neoplasms/Carcinoma,Adenoid Cystic/Radiotherapy Dosage/local recurrence/survival analysis引用本文复制引用
武骏,赵茜,周晶,马廷耀,张姝晶,杨国梁,陈晓红..336例头颈部腺样囊性癌术后放疗剂量与预后相关分析[J].中国耳鼻咽喉头颈外科,2025,32(5):273-278,6.基金项目
国家自然科学基金项目(82173312、82372967) （82173312、82372967）
首都卫生发展科研专项(2022-2-2057) （2022-2-2057）
