[1]戴 皓,李化静,申 震,等.复发性腮腺恶性肿瘤35例诊治分析[J].陕西医学杂志,2020,49(1):87-89.
　DAI Hao,LI Huajing,SHEN Zhen,et al.Diagnosis and treatment of 35 cases of recurrent parotid malignant carcinoma[J].,2020,49(1):87-89.
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复发性腮腺恶性肿瘤35例诊治分析
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
49
期数:
2020年1期
页码:
87-89
栏目:
临床研究
出版日期:
2020-01-05

文章信息/Info

Title:
Diagnosis and treatment of 35 cases of recurrent parotid malignant carcinoma
文章编号:
DOI:10.3969/j.issn.10007377.2020.01.023
作者:
戴 皓1; 李化静1 ; 申 震1 ; 邵 渊1; 白艳霞1; 张少强1; 陈 馨2△; ELENA TAHIR1（巴基斯坦）
1．西安交通大学第一附属医院耳鼻咽喉头颈外科（西安710061）；2．陕西省宝鸡市中心医院耳鼻咽喉头颈外科（宝鸡 721008）
Author(s):
DAI Hao; LI Huajing; SHEN Zhen; et al.
Department of Otolaryngology Head and Neck Surgery,the First Affiliated Hospital of Xi’an Jiaotong University (Xi’an 710061)
关键词:
腮腺恶性肿瘤; 复发; Frey综合征; 涎腺瘘; 皮瓣
Keywords:
Key words Parotid gland carcinoma; Recurrence; Frey syndrome; Salivary gland fistula; Flap
分类号:
R739.6
文献标志码:
A
摘要:
摘 要 目的:探讨复发性腮腺恶性肿瘤的临床诊治思路和诊疗方法。方法:回顾35例复发性或转移性腮腺恶性肿瘤病例，收集临床资料后进行统计分析。结果：35例患者均在首次治疗后18个月内复发，再次手术者瘤体残存33例（94.3%），面神经受侵者17例（48.6%），颈部淋巴结转移者21例（60.0%），远处转移2例（5.8%），随访期间死亡6例。结论：复发性腮腺恶性肿瘤常以局部复发为主，易发生面神经受累和颈部淋巴结转移。再次手术时应选择腮腺全切术，根据病理类型、临床分期、面神经受侵程度选择保留或离断面神经，颈淋巴结阴性者需依据病理类型进行选择性颈淋巴结清扫术。术后辅助放化疗对复发及转移病例的预后有一定改善作用。对于再次手术形成的较大缺损可使用肌瓣和筋膜瓣修复以预防涎腺瘘及面部畸形。
Abstract:
Abstract Objectives:To explore and analyze the clinical diagnosis and treatment of recurrent parotid malignant tumor.Methods: 35 cases of recurrent or metastatic parotid malignancies were reviewed,and clinical data were collected for statistical analysis.Results: 35 patients had recurrence within 18 months after the first treatment,33 patients (94.3%) had residual tumor in the reoperation,17 patients (48.6%) had facial nerve invasion,21 patients (60.0%) had cervical lymph node metastasis,2 patients (5.8%) had distant metastasis.6 patients died during followup.Conclusion: Recurrent parotid malignant tumors are mainly local recurrence,which are prone to facial nerve involvement and cervical lymph node metastasis.Total parotidectomy should be selected for the next operation.The reserved or removed facial nerve should be selected according to the pathological type,clinical stage and degree of nerve invasion.Patients with negative cervical lymph node should undergo selective neck lymph node dissection according to the pathological type.Postoperative adjuvant radiotherapy and chemotherapy can improve the prognosis of patients with recurrence and metastasis.Muscle flap and fascial flap can be used to repair the large defect after reoperation,so as to prevent salivary gland fistula and facial deformity.

参考文献/References:

[1] Witt RL.Major salivary gland cancer[J]. Surg Oncol Clin NAm，2004，13(1):113127.
[2] 陈少卿,刘 钰,黎 军，等.103例腮腺癌的治疗疗效和预后因素分析[J].中国肿瘤临床，2014,41（12）:797800.
[3] Andry G,Hamoir M,Locati LD,et al. Management of salivary gland tumors [J]. Expert Rev Anticancer Ther，2012,12（9）:11611168. 
[4] Stodulski D,Mikaszewski B,Stankiewicz C. Are all prognostic factors in parotid gland carcinoma well recognized? [J]. Eur Arch Otorhinolaryngol， 2012,269(3):10191025.
[5] 李 兖.腮腺恶性肿瘤的临床特征及预后因素分析[J].实用癌症杂志，2015,30（603）：383385.
[6] 曾婉婷，陈彦任，谭 韵，等，腮腺恶性肿瘤临床病理分析81例[J].山东大学耳鼻喉眼学报，2016,30(6)：104106.
[7] Zheng G,Liu J,Zhang H,et al. The efficacy observation of 174 cases of malignant tumor of salivary gland[J].Journal of Basic and Clinical Oncology,2012,25(1):3334.
[8] 梁 忠，郭 良，赵坚强.284例腮腺癌的临床治疗分析[J].肿瘤学杂志，2013,19（6）：466468.
[9] 俞光岩.涎腺肿瘤的诊断和治疗指南.中华口腔医学杂志,2010,45（3）：131133.
[10] 王佳峰，谭 卓，邵 岚，等.涎腺腺样囊性癌远处转移规律及其影响因素分析[J].肿瘤学杂志，2017,23（4）：290294.
[11] 严丹青，闵 翔，刘 凯.巨大复发性腮腺肿瘤切除1例[J].临床耳鼻咽喉头颈外科杂志，2016,30(6)：498499.
[12] 张 凯，李春明.腮腺肿瘤术后面部畸形与Frey综合征综合防治的研究进展[J].口腔医学研究，2019,35(1)：2022.
[13] Lee CC，Chan RC，Chan JY．Predictors for frey syndrome development after parotidectomy[J]．Ann Plast Surg，2017，79(1)：3941．
[14] Mantsopoulos K， Koch M． Extracapsular dissection as sole therapy for small lowgrade malignant tumors of the parotid gland[J]．Laryngoscope，2017，127(8)：18041807．
[15] 朱军利，夏 琪，马 浩.69例腮腺肿瘤术后并发症的危险因素分析[J].实用癌症杂志，2019,34（7）：11441146.
[16] Teymoortash A，Werner JA. Value of neck dissection in patients with cancer of the parotid gland and a clinical neck[J]. Onkologie，2002，25(2):122126.
[17] 周亚燕，李先明，龚 龙,等. 52例腮腺恶性肿瘤患者的临床分析[J].中国癌症杂志，2013,23（4）：302307.
[18] 周 晨，刘树铭，石 妍,等. 125I放射性粒子治疗复发性腮腺癌24例临床分析[J]. 中华放射医学与防护杂志，2017，37（6）：447450.
[19] Viscuse PV,Price K.Marked responses to pemetrexed chemotherapy for metastatic adenocarcinoma of the parotid gland:Case series[J].Head & neck,2019,41(6),E99E103.

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更新日期/Last Update: 2020-02-17