新辅助化疗病理完全缓解对晚期头颈部鳞状细胞癌患者长期生存的影响。

Influence of pathologic complete response to neoadjuvant chemotherapy on long-term survival of patients with advanced head and neck squamous cell carcinoma.

机构信息

State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, People's Republic of China.

出版信息

Oral Surg Oral Med Oral Pathol Oral Radiol. 2013 Feb;115(2):218-23. doi: 10.1016/j.oooo.2012.09.084. Epub 2012 Dec 20.

DOI:10.1016/j.oooo.2012.09.084

PMID:23265986

Abstract

OBJECTIVE

The aim of this study was to analyze whether pathologic complete response (PCR) to neoadjuvant chemotherapy (NAC) affected long-term survival in advanced head and neck squamous cell carcinoma (HNSCC) patients.

MATERIALS

All patients with advanced HNSCC were previously untreated and underwent NAC followed by surgery. The 5-year overall survival, disease-free survival, local control rate, and reasons for treatment failure were analyzed.

RESULTS

A total of 101 cases were included, and the response rate to NAC was 67.3%, including 17 patients (16.8%) who achieved PCR. The 5-year overall survival (OS) of the PCR group (82.4%; histologically complete response group [HCG]) was higher than that of the pathologic incomplete responder group (45.4%; histologically incomplete response group [HICG]) (P = 0.045). No statistically significant difference was noted between the two groups in terms of local recurrence and nodal recurrence, but the local control rate in HCG (88.2%) was higher than that in HICG (62.7%) (P = 0.034).

CONCLUSIONS

Achieving PCR could improve locoregional control and long-term survival in patients with advanced HNSCC.

摘要

目的

本研究旨在分析新辅助化疗（NAC）后的病理完全缓解（PCR）是否影响晚期头颈部鳞状细胞癌（HNSCC）患者的长期生存。

材料

所有晚期 HNSCC 患者均未经治疗，接受 NAC 后行手术治疗。分析了 5 年总生存率、无病生存率、局部控制率和治疗失败的原因。

结果

共纳入 101 例患者，NAC 的缓解率为 67.3%，包括 17 例（16.8%）患者达到 PCR。PCR 组（病理完全缓解组[HCG]）5 年总生存率（OS）（82.4%）高于病理不完全缓解组（45.4%）（组织学不完全缓解组[HICG]）（P = 0.045）。两组局部复发和淋巴结复发无统计学差异，但 HCG 组（88.2%）的局部控制率高于 HICG 组（62.7%）（P = 0.034）。