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Clinical analysis on primary salivary gland type nasopharyngeal carcinoma
CAO Cai-neng,ZHANG Xi-mei, LUO Jing-wei,XU Guo-zhen,GAO Li,YI Iun-lin,HUANG Xiao-dong, XIAO Jian-ping,LI Su-yan
Department of Radiation Oncology,Cancer Hospital (Institute),Chinese Academy of Medical Sciences,Peking Union Medical College,Beijing 100021,China Corresponding author:LUO Jing-wei,Email:nqluo@yahoo.com.cn
Abstract Objective To analyze the clinical characteristics, therapeutic outcomes, and prognostic factors of primary salivary gland type nasopharyngeal carcinoma (SNPC). Methods The medical records of 54 patients with SNPC at single institution between 1963 and 2006 were reviewed, 2 patients received surgery alone, 30 patients received radiotherapy alone and 22 patients received combined modality therapy consisting of surgery (S) and radiotherapy (RT)(S+RT in 15 and RT+S in 7). Of them, 8 patients received chemotherapy, including post-operative adjuvant chemotherapy in 1 patient, palliative chemotherapy in 6 patients and concurrent chemotherapy in 1 patient. 36 patients had adenoid cystic carcinoma (ACC), 11 mucoepidermoid carcinoma (MEC), and 7 primary traditional adenocarcinoma (AC). The Kaplan-Meier method was used to calculate the overall survival (OS), locoregional failure-free survival (LRFFS),and distant failure-free survival (DFFS) rates. Univariate analyses were performed using the Log-rank method. Comparisons of variables between cases were performed using Pearson chi-square test. Results The follow-up was 89%.The 2-,and 5-year overall survival rates, loco-regional failure free survival rates and distant failure free survival rates were 85% and 61%, 74% and 55%, 92% and 70%, respectively. Among the 35 patients with treatment failure, 26 patients had locoregional failure (1 in primary site and cervical lymph node,23 in primary site and 2 in cervical lymph node),and 13 had distant metastasis. The lung was the most common site of metastasis (n=10), followed by liver (n=3), bone (n=2), brain (n=1), and subcutaneous tissue (n=1). Univariate analyses indicated that histological subtypes correlated with overall survival (χ2=15.29,P=0.000) and cervial lymph node metastases correlated with distant failure-free survival (χ2=9.08,P=0.003). Conclusions Primary salivary gland type nasopharyngeal carcinoma is a locally aggressive disease with a long course. The optimal treatment policy for patients with SNPC may be surgery plus radiotherapy.
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2012, Vol. 21 
