Ampil Federico L, Kim David D, Ghali Ghali E, Baluna Roxana G
Division of Therapeutic Radiology, Louisiana State University Health Sciences Center, Shreveport, LA 71130, USA.
J Oral Maxillofac Surg. 2012 Mar;70(3):730-3. doi: 10.1016/j.joms.2011.03.037. Epub 2011 Jul 23.
Given the differences in treatment objectives among oncologists and complexities of standards of therapy for advanced head and neck cancer (HNC), we sought to determine whether HNC patients with simultaneous distant metastases (M1) benefit from aggressive therapeutic intervention.
Among the 1,988 patients diagnosed with HNC during a 22-year period, 7 patients with synchronous M1 tumors were identified. Of these individuals, 4 were treated with a prolonged course of radiotherapy for HNC (group A) and 3 were not (group B).
The median survival and 60-day mortality rate in group A were 14 months and 0%, respectively, whereas the corresponding observations for group B were 5.5 months and 50%. No difference in HNC stage or M1 extent was present between the 2 groups. The patients composing group A were older than those in group B.
These data suggest that some benefit may be obtained by the application of a full course of irradiation for HNC with synchronous M1 disease. The practice of intensive radiotherapy for this particular complicated neoplastic condition needs to be reviewed, considering the health care reform and emphasis on cost-effectiveness in the near future.
鉴于肿瘤学家的治疗目标存在差异以及晚期头颈癌（HNC）治疗标准的复杂性，我们试图确定同时发生远处转移（M1）的HNC患者是否能从积极的治疗干预中获益。
在22年期间诊断为HNC的1988例患者中，确定了7例同步M1肿瘤患者。其中，4例接受了HNC的延长疗程放疗（A组），3例未接受（B组）。
A组的中位生存期和60天死亡率分别为14个月和0%，而B组的相应观察值分别为5.5个月和50%。两组之间的HNC分期或M1范围无差异。A组患者比B组患者年龄大。
这些数据表明，对伴有同步M1疾病的HNC应用全程放疗可能会获得一些益处。考虑到近期的医疗改革以及对成本效益的重视，需要重新审视针对这种特殊复杂肿瘤疾病的强化放疗实践。
