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术后辐射与或没有同时进行化疗的患者与局部先进的头部和部状细胞癌与多个中间风险:一个倾向性得分匹配研究

Thun Leewiboonsilp¹, Chuleepon Jianpinijnan², Nintita Sripaiboonkij Thokanit³

¹Division of Medical Oncology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

Cancer medicine

|March 7, 2025

概括

术后化疗放射治疗 (CRT) 与单独放射治疗 (RT) 相比,没有改善头癌患者的生存率,风险中等. 这一发现可能有助于避免添加化疗的不必要毒性.

科学领域:

在瘤学瘤学.
辐射瘤学辐射瘤学
手术瘤学手术瘤学

背景情况:

术后化学辐射疗法 (CRT) 与单独放射疗法 (RT) 对切除局部晚期头支状细胞癌 (LA-HNSCC) 具有中等风险的益处尚不清楚.
中间风险包括pT3/pT4初级,pN2/pN3结节病,IV/V级结节病,周围神经侵袭 (PNI) 和淋巴血管侵袭 (LVI).

研究的目的:

评估手术后CRT与单独RT在LA-HNSCC患者多种中间风险因素的益处.
为了确定在术后的RT中添加化疗是否会改善该患者群体的结果.

主要方法:

一项倾向分数匹配 (PSM) 研究对LA-HNSCC患者进行,这些患者接受了治疗性手术,并具有中间风险.
对于PSM的共变量包括治疗,性别,年龄,AJCC阶段,LVI和PNI.

主要成果:

在PSM之后,每组CRT和RT组中有48名患者,具有均衡的特征.
具有更多中间风险因素的患者的无事件生存率 (EFS) 显著不同,但整体生存率 (OS) 仅呈现趋势.
在CRT和RT组之间,没有发现中位数OS (4.5与5.0年) 或EFS的显著差异.
与单独RT相比,术后的CRT并没有改善两个或两个以上中间风险因素的患者的OS或EFS.

结论:

在中等风险的LA-HNSCC患者中,术后的CRT没有显示出与单独RT相比的生存益处.
尽管多种中间风险患者的生存率较差,但CRT并没有改善OS或EFS.
这些发现表明,在中等风险的患者中,将化疗添加到术后RT中可能是可以避免的,这可能会降低治疗毒性.

关键词:

在CRT中,CRT可以在CRT中使用.在HNSCC中,我们可以看到.一个辅助的辅助者.化学疗法或放射治疗头部和部状细胞癌瘤中间风险是中间风险.在本地先进的先进.在术后的术后生活.辐射辐射辐射辐射的辐射辐射疗法辐射疗法

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