Adjuvan Radyoterapi İle Tedavi Edilen Baş-Boyun Bölgesi Mukoepidermoid Karsinomlu Hastalarda Sağkalım Sonuçları ve Prognozu Etkileyen Faktörler

Year 2023, , 830 - 835, 30.09.2023

Mursel Duzova , Mustafa Akın

https://doi.org/10.16899/jcm.1345383

Abstract

Amaç: Bu çalışmanın amacı, baş ve boyun bölgesi yerleşimli majör ve minör tükürük bezlerinden kaynaklanan mukoepidermoid karsinom (MEC) nedeniyle cerrahi olan ve ameliyat sonrası radyoterapi uygulanan hastaların sonuçlarıyla bağlantılı klinik ve patolojik faktörleri belirlemekti.
Gereç ve Yöntem: Bu retrospektif çalışmada, baş ve boyundaki majör ve minör tükürük bezlerinde MEC nedeniyle cerrahi ve ardından radyoterapi uygulanan 42 hastanın tıbbi kayıtları, genel sağkalımın klinikopatolojik belirleyicilerini tanımlamak için analiz edildi. İkincil sonlanım noktaları lokal-bölgesel kontrol, uzak metastazsız sağkalım ve hastalıksız sağkalımı kapsamaktaydı.
Bulgular: Hasta kohortunun medyan yaşı 56 olup, %52,4'ü erkek ve %47,6'sı kadındı. Ortanca takip süresi 36 ay olup, aralık 6 ila 88 ay arasındaydı. Tüm hastalara küratif cerrahi ve ardından adjuvan radyoterapi uygulandı. Genel sağkalım (OS), lokal-bölgesel nükssüz sağkalım (LRFS), uzak metastazsız sağkalım (DMFS) ve hastalıksız sağkalım (DFS) için 2 yıllık ve 5 yıllık oranlar sırasıyla %92 ve %72,6, %92,2 ve %85,6, %84,8 ve %73, %82 ve %67,3 idi. Sadece histolojik grade istatistiksel olarak anlamlı bir prognostik faktör olarak bulundu ve hem OS (p=0.019), hem DMFS (p=0.014), hem de DFS'yi (p=0.044) etkiledi.
Sonuç: Tümörün histolojik derecesi MEC olgularının sonuçlarını etkileyen en önemli belirleyicidir. Adjuvan radyoterapi yüksek dereceli tümörler için önerilirken, düşük dereceli ve orta dereceli tümörler için uygulanması beklenen nüks riskine göre bireyselleştirilmelidir. Bu durum, tedavi yaklaşımlarının histolojik özelliklere göre uyarlanmasının önemini vurgulamaktadır.

Keywords

Mukoepidermoid karsinom, Tükürük bezleri, Baş ve boyun kanseri, Histolojik derece, Radyoterapi

Survival Outcomes and Factors Affecting Prognosis in Patients with Head and Neck Region Mucoepidermoid Carcinoma Treated with Adjuvant Radiotherapy

Abstract

Aim: This study aims to ascertain the clinical and pathological factors linked to the outcomes of patients subjected to surgical intervention and postoperative radiotherapy for mucoepidermoid carcinoma (MEC) originating from both major and minor salivary glands in the head and neck region.
Material and Method: In this retrospective review, medical records of 42 patients who underwent surgery and subsequent radiotherapy for localized MEC in the major and minor salivary glands of the head and neck were analyzed to identify clinicopathological determinants of overall survival. Secondary endpoints encompassed local-regional control, distant metastasis-free survival, and disease-free survival.
Results: The median age of the patient cohort was 56 years, comprising 52.4% males and 47.6% females. The median follow-up period spanned 36 months, with a range of 6 to 88 months. All patients underwent curative surgery, followed by adjuvant radiotherapy. The 2-year and 5-year rates for overall survival (OS), local-regional recurrence-free survival (LRFS), distant metastasis-free survival (DMFS), and disease-free survival (DFS) were 92% and 72.6%, 92.2% and 85.6%, 84.8% and 73%, 82% and 67.3%, respectively. Notably, only histologic grade emerged as a statistically significant prognostic factor, influencing both OS (p=0.019), DMFS (p=0.014), and DFS (p=0.044).
Conclusion: The histologic grade of the tumor is the foremost determinant impacting the outcomes of MEC cases. Adjuvant radiotherapy is recommended for high-grade tumors, while its application for low-grade and intermediate-grade tumors should be individualized based on the anticipated risk of recurrence. This underscores the significance of tailoring treatment approaches according to histologic characteristics.

Keywords

Mucoepidermoid carcinoma, Salivary glands, Head and neck cancer, Histological grade, Radiotherapy

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