复发性口咽鳞状细胞癌的挽救性治疗。
Salvage treatment for recurrent oropharyngeal squamous cell carcinoma.
机构信息
Clinic of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.
出版信息
Head Neck. 2010 Aug;32(8):989-96. doi: 10.1002/hed.21273.
BACKGROUND
This study evaluates the oncological outcome of patients with recurrent oropharyngeal squamous cell carcinoma (OPSCC) after primary radiation therapy +/- chemotherapy, primary surgical therapy, and surgical therapy followed by radiation therapy +/- chemotherapy.
METHODS
A total of 156 patients (36%) of a cohort of 427 treated for OPSCC between 1990 and 2006 developed recurrent disease. Fifty-one patients (12%) qualified for salvage treatment. Study endpoints were 5-year overall survival (OS) and disease-specific survival (DSS).
RESULTS
The 5-year OS and DSS rates after salvage treatment were 29% and 40%; after initial primary radiation therapy, 25% and 40%; after initial surgery followed by radiation therapy, 40% and 40%; and after initial surgery alone, 20% and 40%.
CONCLUSIONS
Patients with an advanced OPSCC have a considerable risk for recurrence. Despite poor ultimate outcome, salvage treatment should be attempted in patients with resectable disease, good performance status, and absence of distant metastases.
背景
本研究评估了初治为放疗±化疗、手术治疗、以及术后放疗±化疗的复发性口咽鳞状细胞癌（OPSCC）患者的肿瘤学结局。
方法
1990 年至 2006 年间，427 例 OPSCC 患者中有 156 例（36%）出现疾病复发。51 例（12%）患者符合挽救性治疗条件。研究终点为 5 年总生存率（OS）和疾病特异性生存率（DSS）。
结果
挽救性治疗后 5 年 OS 和 DSS 率分别为 29%和 40%；初治放疗后分别为 25%和 40%；初治手术+放疗后分别为 40%和 40%；初治手术单独治疗后分别为 20%和 40%。
结论
OPSCC 患者有相当大的复发风险。尽管最终预后较差，但对于可切除疾病、良好的一般状态和无远处转移的患者，应尝试挽救性治疗。
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