在头部和部癌症外节扩张的风险分层-治疗强化治疗的含义
Smriti Panda1, Rajeev Kumar2, Aanchal Kakkar3
1Department of ENT-Oncology, National Cancer Institute - All India Institute of Medical Sciences (Jhajjar Campus), Jhajjar, Haryana, India.
Head & neck
|March 28, 2025
概括
在头部和部癌症中,节外延伸 (ENE) 的2mm切断值并不能有效预测存活率. 4毫米的切线更好地预测结果,并识别了从辅助化疗辐射中受益的患者.
科学领域:
- 在瘤学瘤学.
- 病理学 病理学 病理学
背景情况:
- 外节延伸 (ENE) 是头癌的关键不良预后因素.
- 目前对ENE的风险分层需要对最佳切割值和与其他风险因素的相互作用进行细化.
研究的目的:
- 为了评估不同突节外延伸 (ENE) 切断在头癌的预后意义.
- 确定最佳的ENE程度切线,以预测存活率和对辅助治疗的反应.
主要方法:
- 对以前没有接受过治疗的头癌患者的回顾性分析,在组织学上确认了ENE.
- 使用 2mm 和 4mm ENE 截止值,比较生存结果 (OS 和 DFS).
- 接收机-运营商曲线 (ROC) 分析,以确定最佳的ENE切断点.
- 基于ENE范围的辅助化学辐射 (CRT) 益处的评估.
主要成果:
- 对于ENE的标准2mm切线,整体存活率 (OS) 或无病存活率 (DFS) 没有显著差异.
- 在ROC的分析中,发现4毫米的切断距离对DFS具有最好的预测能力.
- 宏观ENE (Ma-ENE) 患者表现出辅助CRT的显著生存益处,与显微ENE (Mi-ENE) 患者不同.
- 4毫米的切断率预测了辅助CRT的治疗益处.
- 瘤位置,T阶段,侵袭深度,结节转移负担和男性性别是与ENE相互作用的显著临床病理因素.
结论:
- 对于ENE范围的2mm切线缺乏足够的OS和DFS在头癌中的危险歧视.
- 通过ROC分析确定的ENE范围的4mm切割值显示了DFS的优异预测能力.
- 4毫米的切断值对于预测辅助CRT的治疗反应非常有价值,特别是对Ma-ENE.
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