Pond Gregory R, Milowsky Matthew I, Kolinsky Michael P, Eigl Bernhard J, Necchi Andrea, Harshman Lauren C, Di Lorenzo Giuseppe, Dorff Tanya B, Lee Richard J, Sonpavde Guru
McMaster University, Hamilton, Ontario, Canada.
University of North Carolina, Chapel Hill, NC.
Clin Genitourin Cancer. 2014 Dec;12(6):440-6. doi: 10.1016/j.clgc.2014.03.009. Epub 2014 Mar 27.
Outcomes with concurrent chemoradiotherapy for penile squamous cell carcinoma (PSCC) are unclear, and only anecdotal reports have been published. This study was a retrospective analysis of patients who received concurrent chemotherapy and radiotherapy for PSCC.
Individual patient-level data were obtained from 5 institutions for outcomes with concurrent chemoradiotherapy for PSCC. Descriptive statistics were calculated, and univariable Cox proportional hazards regression analysis was conducted to examine the prognostic effect of candidate factors on progression-free survival (PFS) and overall survival (OS).
A total of 26 men were evaluable. The mean age was 60.3 years. The clinical stage was ≤ III in 9 patients (36%) and stage IV in the rest. Soft tissue and visceral metastasis were present in 35% and 20% of patients, respectively. The chemotherapy was cisplatin-based in 92.3% of patients, and the median (range) of external beam radiotherapy administered was 4900 cGy (range, 1800-7000 cGy). The median OS was 6.9 months (95% CI, 5-14), and the median PFS was 5.1 months (95% CI, 2.5-7.0). When excluding patients with M1 disease, the remaining patients (n = 21) had a median OS and PFS of 10.0 months (95% CI, 5-14) and 6.0 months (95% CI, 2.0-7.0), respectively. Baseline neutrophil to lymphocyte ratio (NLR) was significantly associated with survival, and visceral metastasis showed a trend for association with OS.
Concurrent chemoradiotherapy demonstrated poor outcomes for locally advanced PSCC. Better understanding of tumor biology and study of novel combinations of biologic agents with radiation are warranted.
阴茎鳞状细胞癌（PSCC）同步放化疗的疗效尚不清楚，仅有一些个案报道发表。本研究是对接受PSCC同步放化疗患者的回顾性分析。
从5家机构获取了PSCC同步放化疗患者的个体水平数据。计算描述性统计量，并进行单变量Cox比例风险回归分析，以检验候选因素对无进展生存期（PFS）和总生存期（OS）的预后影响。
共有26名男性患者可进行评估。平均年龄为60.3岁。9例患者（36%）临床分期≤Ⅲ期，其余患者为Ⅳ期。分别有35%和20%的患者出现软组织和内脏转移。92.3%的患者化疗以顺铂为基础，外照射放疗的中位剂量（范围）为4900 cGy（范围，1800 - 7000 cGy）。中位OS为6.9个月（95%CI，5 - 14），中位PFS为5.1个月（95%CI，2.5 - 7.0）。排除M1期疾病患者后，其余患者（n = 21）的中位OS和PFS分别为10.0个月（95%CI，5 - 14）和6.0个月（95%CI，2.0 - 7.0）。基线中性粒细胞与淋巴细胞比值（NLR）与生存显著相关，内脏转移与OS有相关趋势。
同步放化疗对局部晚期PSCC显示出较差的疗效。有必要更好地了解肿瘤生物学，并研究生物制剂与放疗的新型联合方案。
