Thariat Juliette, Ahamad Anesa, El-Naggar Adel K, Williams Michelle D, Holsinger Floyd C, Glisson Bonnie S, Allen Pamela K, Morrison William H, Weber Randal S, Ang K Kian, Garden Adam S
Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA.
Cancer. 2008 Jun 15;112(12):2698-709. doi: 10.1002/cncr.23486.
Basaloid squamous cell carcinoma (BSCC) is an uncommon, high-grade variant of squamous cell carcinoma (SCC) of the head and neck. Its poorer prognosis compared with common SCC remains controversial. The authors investigated the outcomes of patients with BSCC who received radiotherapy and compared them with the outcomes of patients with SCC.
From 1994 to 2004, 1007 patients received radiotherapy for head and neck carcinoma with lymph node involvement. The histologic types consisted of 51 BSCC, 431 poorly differentiated SCC (PSCC), and 525 well or moderately differentiated SCC (WMSCC). A case-control analysis was performed with BSCC matched against both PSCC and WMSCC to compare disease-control and survival rates.
Patients with BSCC received treatment modalities similar to those received by patients with SCC: They received induction chemotherapy (12%) or concurrent chemotherapy (33%), and a median radiation dose of 70 Gray. Posttreatment viable tumor was present in 44%, 13%, and 28% of neck dissection specimens from patients with BSCC, PSCC, and WMSCC, respectively. The 5-year disease-free survival rates (63%, 77%, and 76%, respectively) and overall survival rates (85%, 70%, and 71%, respectively) demonstrated no statistically significant differences for BSCC, PSCC, or WMSCC, respectively.
In this study, a poorer prognosis could not be demonstrated for irradiated patients with BSCC compared with either PSCC or WMSCC. All patients in this study had positive lymph node status, and the majority of patients (84%) had oropharyngeal cancer. The BSCC cohort did have a relatively high rate of viable tumor in their posttreatment neck dissections, and they had a relatively high rate of distant disease. On the basis of the high rate of lung metastases and the possibility of efficient salvage, the authors recommend obtaining a chest computed tomography scan during initial staging and follow-up.
基底样鳞状细胞癌（BSCC）是头颈部鳞状细胞癌（SCC）中一种罕见的高级别变异类型。与普通SCC相比，其预后较差这一点仍存在争议。作者调查了接受放疗的BSCC患者的治疗结果，并将其与SCC患者的结果进行比较。
1994年至2004年，1007例头颈部癌伴淋巴结转移患者接受了放疗。组织学类型包括51例BSCC、431例低分化SCC（PSCC）和525例高分化或中分化SCC（WMSCC）。进行病例对照分析，将BSCC与PSCC和WMSCC进行匹配，以比较疾病控制率和生存率。
BSCC患者接受的治疗方式与SCC患者相似：他们接受诱导化疗（12%）或同步化疗（33%），中位放疗剂量为70格雷。BSCC、PSCC和WMSCC患者颈部清扫标本中，分别有44%、13%和28%在治疗后仍有存活肿瘤。BSCC、PSCC和WMSCC的5年无病生存率（分别为63%、77%和76%）和总生存率（分别为85%、70%和71%）均无统计学显著差异。
在本研究中，与PSCC或WMSCC相比，接受放疗的BSCC患者并未显示出较差的预后。本研究中的所有患者均有阳性淋巴结状态，且大多数患者（84%）患有口咽癌。BSCC队列在治疗后的颈部清扫中确实有相对较高的存活肿瘤率，且远处疾病发生率相对较高。基于高肺转移率和有效挽救的可能性，作者建议在初始分期和随访期间进行胸部计算机断层扫描。
