辅助化学放射治疗口腔腔SCC与小和主要的外节延伸
Mirko Manojlovic-Kolarski1,2, Susie Su3, Ilian Weinreb4
1Department of Otolaryngology-Head and Neck Surgery, University Health Network, Toronto, Ontario, Canada.
JAMA otolaryngology-- head & neck surgery
|June 18, 2025
概括
辅助化疗改善了口腔癌患者的主要外节延伸 (ENE) 的生存率,但对于那些轻微的ENE患者来说没有显著的好处. 这一发现影响了口腔状细胞癌 (OSCC) 患者的治疗决策.
科学领域:
- 在瘤学瘤学.
- 头部和部手术 头部和部手术
- 癌症研究 癌症研究
背景情况:
- 在口腔状细胞癌 (OSCC) 中,外节延伸 (ENE) 是一个关键的预后因素.
- 辅助化疗放射治疗通常用于OSCC与ENE,但其在轻微的ENE中的益处是不确定的.
- 根据范围,ENE被分为轻微 (≤2毫米) 或重大 (>2毫米) 的类别.
研究的目的:
- 评估辅助化疗或放射治疗对OSCC患者瘤结局的影响.
- 根据外节延伸的程度 (小与大) 具体评估结果.
- 为了澄清辅助治疗在小ENE亚组中的作用.
主要方法:
- 追溯性多中心队列研究,涉及755名手术切除OSCC和阳性节点的患者.
- 2005年至2018年期间在澳大利亚,美国和加拿大中心接受治疗的患者.
- 分析包括单变量,多变量和倾向得分匹配的方法来评估局部区域控制,无病生存率和按ENE程度分层的总生存率.
主要成果:
- 化疗对小ENE组 (126名患者) 的局部区域控制,无病存活率或总生存率没有显着的益处.
- 相比之下,辅助化疗在主要ENE组 (243名患者) 中显著改善了无病生存率 (HR,0.58) 和总生存率 (HR,0.61).
- 倾向性得分匹配证实了这些发现,显示小ENE没有改善,但主要ENE有显著的DFS和OS好处.
结论:
- 辅助化疗在OSCC中显示出明显的好处,对于OSCC中主要的节外延伸患者来说.
- 这项研究表明,辅助化疗可能对轻微的节外延伸患者没有好处.
- 结果支持基于ENE在OSCC管理中的程度的分层治疗方法.
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