Background: Because of the rarity, heterogeneous histology, and diverse anatomical sites of salivary gland cancer (SGC), there are a limited number of clinical studies on its management. This study reports the cumulative evidence of postoperative radiotherapy (PORT) for SGC of the head and neck. Methods: A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched the PubMed, Embase, Cochrane Library, and Web of Science databases between 7th and 10th November 2023. Results: A total of 2962 patients from 26 studies between 2007 and 2023 were included in this meta-analysis. The median RT dose was 64 Gy (range: 56–66 Gy). The median proportions of high-grade, pathological tumor stage 3 or 4 and pathological lymph node involvement were 42% (0–100%), 40% (0–77%), and 31% (0–75%). The pooled locoregional control rates at 3, 5, and 10 years were 92% (95% confidence interval [CI], 89–94%), 89% (95% CI, 86–93%), and 84% (95% CI, 73–92%), respectively. The pooled disease-free survival (DFS) rates at 3, 5, and 10 years were 77% (95% CI, 70–83%), 67% (95% CI, 60–74%), and 61% (95% CI, 55–67%), respectively. The pooled overall survival rates at 3, 5, and 10 years were 84% (95% CI, 79–88%), 75% (95% CI, 72–79%), and 68% (95% CI, 62–74%), respectively. Severe late toxicity ≥ grade 3 occurred in 7% (95% CI, 3–14%). Conclusion: PORT showed favorable long-term efficacy and safety in SGC, especially for patients with high-grade histology. Considering that DFS continued to decrease, further clinical trials exploring treatment intensification are warranted.
背景：由于涎腺癌（SGC）的罕见性、组织学异质性及解剖部位多样性，其治疗相关的临床研究数量有限。本研究旨在总结头颈部涎腺癌术后放疗（PORT）的累积证据。方法：依据系统综述与荟萃分析优先报告条目（PRISMA）指南进行系统综述。我们于2023年11月7日至10日检索了PubMed、Embase、Cochrane Library和Web of Science数据库。结果：本荟萃分析共纳入2007年至2023年间26项研究的2962例患者。中位放疗剂量为64 Gy（范围：56-66 Gy）。高级别肿瘤、病理肿瘤分期3或4期及病理淋巴结受累的中位比例分别为42%（0-100%）、40%（0-77%）和31%（0-75%）。3年、5年和10年的汇总局部区域控制率分别为92%（95%置信区间[CI]，89-94%）、89%（95% CI，86-93%）和84%（95% CI，73-92%）。3年、5年和10年的汇总无病生存率分别为77%（95% CI，70-83%）、67%（95% CI，60-74%）和61%（95% CI，55-67%）。3年、5年和10年的汇总总生存率分别为84%（95% CI，79-88%）、75%（95% CI，72-79%）和68%（95% CI，62-74%）。≥3级的严重晚期毒性发生率为7%（95% CI，3-14%）。结论：PORT在涎腺癌中显示出良好的长期疗效和安全性，尤其对于高级别组织学类型的患者。鉴于无病生存率持续下降，有必要开展进一步临床试验以探索强化治疗方案。
肿瘤(癌症)患者之家