新人999肿瘤如何治疗配图，仅供参考
5.2. TreatmentCommonly,the treatment of malignant salivary gland tumors is surgical,with removal of the tumor without damaging the facial nerve. Adjuvant radiotherapy and chemotherapy show a better regional control but the overall survival rate is not significantly improved. Clinical trials are now being conducted to identify targeted therapies . Therapeutic agents targeting transmembrane tyrosine kinase receptors ErbB1 such as Cetuximab have been approved for the treatment of conventional squamous cell carcinoma of the head and neck and are being tested for their efficiency in salivary glands ACC,MEC,MC and AclC . ErbB1-targeted therapy with Gefitimid and the selective inhibition of NF-kB activity with Bortezomid in patients with ACC has showed promising results . Targeting the NOTCH1 mutation in ACC with the inhibitor brontictuzumab produced only a partial response under this therapy . Patients with salivary cancer overexpressing ErbB2 (of another member of the tyrosine kinase receptors) or HER-2 have received additional treatment with Trastuzumab. Trastuzumab is a treatment frequently used for HER-2-positive breast cancer in tumors overexpressing immunohistochemically HER-2 protein or HER-2 gene amplification (detected by fluorescence in situ hybridization). Patients with MEC had partial response to Trastuzumab therapy and patients with SDC showed stabile disease after it. Antiangiogenic agents like Axitinib were tested on ACC but the study was limited by the small number of patients with salivary neoplasia enrolled . Specific target therapeutical agents are still tested on salivary gland tumors but there is no standard treatment for these tumors. Some of the studies showed encouraging data.
Immunotherapy targeting programmed cell death protein 1(PD-1)/programmed cell death 1 ligand 1(PD-L1) and cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) have been used for the treatment of solid tumors. However,few clinical trials have been performed on salivary glands tumors. Furthermore,the number of cases and the tumor types included in those trials were few. Patients with AclC,SDC,MEC,ACC and UC and with progressive diseases were included in trials with PD-1 and PDL-1 inhibitor therapies. The results of those studies showed that for salivary gland tumors,immunotherapy can be promising in some histological types,but in aggressive tumors like ACC no effect was noticed. These studies are limited,and only small samples size were analyzed from just some histological subtypes of salivary neoplasms. At this time,the effectiveness of immunotherapy on salivary glands tumors is considered elusive and the studied patients showed no complete responses to the treatment .
Non-surgical treatments such as microwave ablation,radiofrequency ablation and ultrasound-guided ethanol sclerotherapy are proposed as options for the management of WTs. However,the experience with these non-surgical treatments is limited. The studies lacked case controls and included a small number of patients with a 6–12 months follow-up. Further studies are needed to appreciate the effectiveness of these options of treatment for WT .","department":"
