治疗中断和头癌的结果:对3项随机临床试验的二次分析
Laila A Gharzai1, Emily Morris2, Matthew J Schipper2,3
1Department of Radiation Oncology, Northwestern University, Chicago, Illinois.
JAMA otolaryngology-- head & neck surgery
|December 4, 2025
概括
在头部和部状细胞癌 (HNSCC) 中,放射治疗中断与较差的结果有关. 较长的延迟显著增加了局部区域性衰竭的风险,并影响了整体存活率,特别是在局部先进的HNSCC中.
科学领域:
- 在瘤学瘤学.
- 辐射瘤学 辐射瘤学
- 头部和部癌症研究研究
背景情况:
- 历史数据表明,放射治疗 (RT) 的延迟使头部和部状细胞癌 (HNSCC) 的瘤结果恶化.
- 由于癌症治疗计划的频繁中断,COVID-19大流行引起了人们的担忧.
研究的目的:
- 调查放射治疗中断与HNSCC患者的局部区域性衰竭 (LRF) 之间的关联.
- 确定RT中断对HNSCC总生存时间 (OS) 的影响.
主要方法:
- 来自3个随机临床试验 (NRG/RTOG 0129, 0522, 1016) 的1549名患者的回顾性分析,这些患者接受了针对HNSCC的RT治疗.
- 患者被分为p16阳性口腔大 (p16+OPSCC) 和局部发达的HNSCC (LAHNSCC).
- 考克斯的比例危险模型评估了RT中断 (二进制和连续) 与LRF和OS的关联.
主要成果:
- 七天的RT中断与增加的风险相对应:LRF的HR1.45和OS的HR1.41.
- 平均7天的中断与p16+OPSCC中的4.1%LRF降低和LAHNSCC中的9.1%相关.
- RT中断对LRF的负面影响因p16状态和临床因素而异,从2.0%到11.2%不等.
结论:
- 放射治疗中断与HNSCC中的LRF和OS负相关.
- 这种关联的程度因p16状态和临床特征而异.
- 应避免中断治疗,特别是对于LAHNSCC或更高阶段疾病的患者.
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