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患者报告的吞结果在HPV+口腔癌通过术后化学辐射剂量在MINT和E331111中

Theresa Tharakan¹, Sidharth V Puram^1,2, Randal C Paniello¹

¹Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St Louis, Missouri, USA.

Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery

|May 28, 2025

概括

减强的术后辅助 (化疗) 辐射疗法 (POA(C) RT) 在HPV阳性口腔状细胞癌 (OPSCC) 患者中没有显著影响患者报告的消化不良结果. 在各种辐射剂量中,失消症得分保持相似,这表明减强策略的安全性.

科学领域:

在瘤学瘤学.
头部和部手术头部和部手术
辐射瘤学辐射瘤学
患者报告的结果

背景情况:

人类乳头瘤病毒阳性口腔状细胞癌 (HPV+OPSCC) 的治疗通常涉及横口机器人手术,其次是辅助性 (化疗) 辐射疗法 (POA(C) RT).
正在探索POA(C) RT的减强,以减轻长期副作用,如食障碍,同时保持瘤控制.
患者报告的结果,特别是吞功能,对于评估治疗耐受性和生活质量至关重要.

研究的目的:

评估减强POA的影响C) RT在HPV+OPSCC患者患者报告的食障碍结局.
为了比较透口机器人手术后不同辐射疗法 (RT) 剂量组的消化不良结果.

主要方法:

追溯多机构研究 (2014-2021),包括156名HPV+OPSCC患者,他们接受过口腔机器人手术和POA(C) RT.
患者接受RT剂量在42至60Gy之间,按风险分层,包括不同的思思丁治疗方案.
主要结局是MD Anderson Dysphagia Inventory (MDADI) 复合得分从基线到治疗后1年的变化,临床上有意义的下降 (CMD) 定义为≥10分.

主要成果:

一年后MDADI得分的平均变化在RT剂量组之间没有显著差异 (42-49 Gy,50-59 Gy,60 Gy;ANOVA P=.46).
临床上有意义的下降率 (CMD) 在消化障碍是相似的跨剂量组: 39% (42-49 Gy), 52% (50-59 Gy),和44% (60 Gy;千平方P=.42).
在接受42-49 Gy,有或没有西斯普拉丁的患者中,CMD的发病率是可比的,所有剂量组中胃口管的发病率都相似.

结论:

在42至60Gy的范围内,减强的术后辅助 (化疗) 辐射疗法 (POA(C) RT不会导致与失调相关的生活质量发生显著不同的变化.
这些发现表明,在POA(C) RT设置中减少HPV+OPSCC的辐射剂量可能是关于吞功能结果的安全策略.
对最佳减强策略的进一步研究是有必要的,以平衡瘤疗效与功能性保存.

关键词:

在HPV+口腔喉皮状细胞癌.作为辅助剂的辐射剂量.失足症是一种失足症.患者报告的结果.

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