上颌窦鳞状细胞癌N0颈部患者的选择性颈部放疗与观察：一项荟萃分析及文献综述
Elective neck irradiation versus observation in squamous cell carcinoma of the maxillary sinus with N0 neck: A meta-analysis and review of the literature.
作者信息
Abu-Ghanem Sara, Horowitz Gilad, Abergel Avraham, Yehuda Moshe, Gutfeld Orit, Carmel Narin-Nard, Fliss Dan M
机构信息
Department of Otolaryngology Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, affiliated to the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Department of Radiation Oncology, Tel-Aviv Sourasky Medical Center, affiliated to the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
出版信息
Head Neck. 2015 Dec;37(12):1823-8. doi: 10.1002/hed.23791. Epub 2014 Aug 1.
BACKGROUND
Elective neck irradiation of a clinical node-negative (N0) neck in squamous cell carcinoma (SCC) of the maxillary sinus is a controversial issue.
METHODS
A systematic review of electronic databases and a meta-analysis were conducted to clarify the role of elective neck irradiation in patients with SCC of the maxillary sinus and clinical N0 neck. Regional (neck) nodal recurrence was chosen as the primary endpoint.
RESULTS
Four retrospective studies with a total of 129 patients met the inclusion criteria. The results of the meta-analysis showed that elective neck irradiation reduced the risk of regional nodal recurrence (fixed effects model: odds ratio [OR] = 0.16; 95% confidence interval [CI] = 0.04-0.67; p = .01; random-effects model: OR = 0.17; 95% CI = 0.04-0.76; p = .02) compared to observation.
CONCLUSION
This systemic review and first meta-analysis confirmed that elective neck irradiation can significantly reduce the rate of nodal recurrence in patients with N0 SCC of the maxillary sinus.
背景
上颌窦鳞状细胞癌（SCC）患者临床颈部淋巴结阴性（N0）时，选择性颈部照射是一个有争议的问题。
方法
对电子数据库进行系统评价并进行荟萃分析，以阐明选择性颈部照射在上颌窦SCC且临床颈部N0患者中的作用。将区域（颈部）淋巴结复发作为主要终点。
结果
四项回顾性研究共纳入129例患者，符合纳入标准。荟萃分析结果显示，与观察相比，选择性颈部照射降低了区域淋巴结复发风险（固定效应模型：比值比[OR]=0.16；95%置信区间[CI]=0.04-0.67；p=0.01；随机效应模型：OR=0.17；95%CI=0.04-0.76；p=0.02）。
结论
该系统评价和首次荟萃分析证实，选择性颈部照射可显著降低上颌窦N0 SCC患者的淋巴结复发率。
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