管理头部和部状细胞癌与N3节点疾病的管理
1Department of Clinical Oncology, Imperial College Healthcare NHS Trust, Fulham Palace Road, London, W6 8RF, UK.
概括
对于N3节点疾病的头角状细胞癌 (HNSCC),放射治疗后的监测对完全响应者,特别是p16阳性患者有效. 初级部剖析可能有利于p16阴性病例.
科学领域:
- 在瘤学瘤学.
- 头部和部手术 头部和部手术
- 辐射疗法 辐射疗法
背景情况:
- 在头部和部状细胞癌 (HNSCC) 中N3节点疾病的管理缺乏明确的指导方针.
- 首部剖析的初级手术与初级放射治疗是治疗选择.
研究的目的:
- 为了比较N3 HNSCC的初级手术管理与初级放射治疗的结果.
- 评估放射治疗后对完全响应者进行监测的作用.
主要方法:
- 对53名T0-4N3M0 HNSCC患者 (不包括鼻初级病例) 的回顾性审查.
- 患者接受了初级手术和部剖析,随后进行放射治疗或初级放射治疗,并对完全反应进行监测.
- 通过成像评估的反应,包括PET-CT,在放射治疗后平均16周.
主要成果:
- 初级手术的两年总生存率为64%,初级放射治疗的55%.
- 放射治疗后的完整反应产生了87%的存活率,p16阳性完整反应者为92%.
- PET-CT比CT更好地预测了无病生存期;p16阳性患者的完整反应率更高 (63%vs25%).
结论:
- 监测是放射治疗完全响应者,特别是p16阳性HNSCC患者的可行策略,避免部剖析发病率.
- 对于p16阴性HNSCC患者来说,初级部剖析可能是可取的,因为这些患者不太可能达到完全反应.
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