诺莫图谱用于风险适应性估计,对病理性N0口腔癌的术后放射治疗后的区域控制效益进行风险适应性估计:回顾性分析
Max Gau1, Jie Su1, Shao Hui Huang1
1Department of Radiation Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Ontario, Canada.
International journal of radiation oncology, biology, physics
|September 19, 2025
概括
这项研究开发了一种名谱,用于预测口腔状细胞癌 (OSCC) 患者的局部区域性衰竭 (LRF). 手术后放射治疗 (PORT) 在中期和高风险组显著降低了LRF,改善了生存率.
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
背景情况:
- 口腔状细胞癌 (OSCC) 具有局部区域性衰竭 (LRF) 的显著风险.
- 准确的风险分层对于优化辅助治疗决策至关重要,包括术后放射治疗 (PORT).
- 现有的模型可能无法完全捕捉早期OSCC中LRF风险的细微差别.
研究的目的:
- 在切除,节点阴性OSCC (pT1-pT4N0) 患者中构建局部区域性衰竭 (LRF) 的预测性名录.
- 在定义的风险组内量化术后放射治疗 (PORT) 与LRF风险之间的关联.
- 帮助个性化治疗决策,用于OSCC的辅助疗法.
主要方法:
- 在1994年至2017年期间在四个癌症中心接受治疗的1094名pT1-pT4N0M0OSCC患者的回顾性审查.
- 多变量分析确定了显著的预后因素 (pT类别,等级,入侵,边缘状况,部剖析充分性,PORT使用) 和临床病理因素 (副站点,LVI,吸烟) 对于名录构造.
- 根据3年LRF概率,患者被分为四个风险组 (低风险,标准风险,中风险,高风险).
主要成果:
- 纳米图包含了六个显著因素和三个相关的临床病理因素,达到0.66.6的C指数.
- 确定了3年的LRF概率:低 (6%),标准 (12%),中等 (23%) 和高 (27%).
- 在中期 (19%对28%) 和高风险 (22%对38%) 组中,PORT显著降低了三年LRF,改善了整体存活率.
结论:
- 开发的名录和风险分层系统为OSCC的辅助治疗决策提供了临床相关的工具.
- 命名图有助于估计PORT在减少LRF方面的个人益处.
- 在广泛临床应用之前,建议进行前性验证.
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