Radiation Oncology Journal

The Korean Society for Radiation Oncology (대한방사선종양학회)
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Postoperative Radiotherapy for Parotid Gland Malignancy

귀밑샘 악성 종양의 수술 후 방사선 치료

  • Eom Keun-Yong (Departments of Radiation Oncology, Seoul National University College of Medicine) ;
  • Wu Hong-Gyun (Departments of Radiation Oncology, Institute on Radiation Medicine, Medical Research Center, Cancer Research Institute, Seoul National University College of Medicine) ;
  • Kim Jae-Sung (Departments of Radiation Oncology, Institute on Radiation Medicine, Medical Research Center, Cancer Research Institute, Seoul National University College of Medicine) ;
  • Park Charn Il (Departments of Radiation Oncology, Institute on Radiation Medicine, Medical Research Center, Seoul National University College of Medicine) ;
  • Kim In-Ah (Department of Radiation Oncology, Bundang Seoul National University Hospital) ;
  • Kim Kwang Hyun (Departments of Otorhinolarynogology and Head & Neck Surgery, Seoul National University College of Medicine) ;
  • Lee Chae Seo (Departments of Otorhinolarynogology and Head & Neck Surgery, Seoul National University College of Medicine)
  • 엄근용 (서울대학교 의과대학 방사선종양학교실) ;
  • 우홍균 (서울대학교 의과대학 방사선종양학교실, 의학연구원 방사선의학연구소, 암연구소) ;
  • 김재성 (서울대학교 의과대학 방사선종양학교실, 의학연구원 방사선의학연구소, 암연구소) ;
  • 박찬일 (서울대학교 의과대학 방사선종양학교실, 의학연구원 방사선의학연구소) ;
  • 김인아 (분당서울대학교병원 방사선종양학과) ;
  • 김광현 (서울대학교 의과대학 이비인후과학교실) ;
  • 이재서 (서울대학교 의과대학 이비인후과학교실)
  • Published : 2005.09.01
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Abstract

Purpose: The aim of this study was to evaluate the clinical results of postoperative radiotherapy for parotid gland malignancy, and determine prognostic factors for locoregional control and survival. Materials and Methods: Between 1980 and 2002, 130 patients with parotid malignancy were registered In the database of the Department of Radiation Oncology, Seoul National University Hospital. The subjects of this analysis were the 72 of these 130 patients who underwent postoperative Irradiation, There were 42 males and 30 females, with a median age of 46.5 years. The most common histological type was a mucoepidermoid carcinoma. There were 6, 23, 23 and 20 patients in Stages I, II, III and IV, respectively. The median dose to the tumor bed was 60 Gy, with a median fraction size of 1.8 Gy. Results: The overall 5 and 10 year survival rates were 85 and $76\%$, respectively, The five-year locoregional control rate was $85\%$, which reached a plateau phase after 6 years. Sex and histological type were found to be statistically significant for overall survival from a multivariate analysis. No other factors, Including age, facial nerve palsy and stage, were related to overall survival. For locoregional control, nodal involvement and positive resection margin were associated with poor local control. Histological type, tumor size, perineural invasion and type of surgery were not significant for locoregional control. Conclusion: A high survival rate of parotid gland malignancies, with surgery and postoperative radiotherapy, was confirmed. Sex and histological type were significant prognostic factors for overall survival. Nodal Involvement and a positive resection margin were associated with poor locoregional control.

목적: 귀밑샘 악성종양의 수술 후 방사선 치료 성적 및 예후인자를 분석하였다. 대상 및 방법: 1980년부터 2002년까지 130명의 귀밑샘 악성 종양 환자가 서울대병원 방사선 종양학과 데이터베이스에 등록되었고 이 중 수술 후 방사선 치료를 받은 72명의 환자에 대하여 후향적 분석을 실시하였다. 남자는 42명, 여자는 30명이었고, 나이의 중앙값은 46.5세였다. 점액표피양암종이 가장 흔한 조직학적 유형이었다. 병기에 따라서는 I, I, III, IV 병기에 각각 6, 23, 23, 20명이 해당되었다. 수술 부위의 방사선 조사량의 중앙값은 60 Gy였고, 일회 조사량의 중앙값은 1.8 Gy였다. 결과: 5년 전체 생존율 및 10년 전체 생존율은 각각 $85\%$와 $76\%$였다. 5년 국소제어율은 $76\%$였고 6년이 지나면서 변화가 없었다. 다변량분석을 하였을 때, 성별, 조직학적 유형이 생존율과 통계적 유의성이 있었다. 나이, 안면신경마비증상, 병기(T 병기, N병기, 병기)는 생존율과 관련된 통계적 유의성이 없었다. 국소제어율의 경우, 림프절 전이 및 절제연 침범여부가 의미있는 예후인자였다. 조직학적 유형, 종양의 크기, 신경침윤여부 및 수술의 종류는 국소제어율의 예후인자가 아니었다. 결론: 귀밑샘 악성종양에서 수술 후 방사선치료의 우수한 성적을 확인하였다. 성별 및 조직학적 유형이 생존율에 대한 의미있는 예후인자였고, 림프절 전이 및 절제연의 침윤이 있는 경우 국소제어율이 불량했다.

Keywords

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