León Xavier, Agüero Adriana, López Montserrat, García Jacinto, Farré Nuria, López-Pousa Antonio, Quer Miquel
Otorhinolaryngology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autónoma de Barcelona, Barcelona, Spain; CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Barcelona, Spain.
Otorhinolaryngology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autónoma de Barcelona, Barcelona, Spain.
Auris Nasus Larynx. 2015 Apr;42(2):145-9. doi: 10.1016/j.anl.2014.10.002. Epub 2014 Nov 13.
To analyze the oncologic outcomes and surgical complications after salvage surgery for recurrence following chemoradiotherapy or bioradiotherapy for advanced head and neck squamous cell carcinoma.
From 2007 to 2011, 187 patients were treated with chemoradiotherapy (n=154) or bioradiotherapy (n=33). Patients treated with bioradiotherapy were older and showed a tendency to poorer general condition. During the follow-up, 43 patients treated with chemoradiotherapy (27.9%) and 13 patients treated with bioradiotherapy (39.3%) had a local recurrence of the tumor. We analyzed the patient candidates to salvage surgery, and the associated complications and outcome of these surgeries.
Sixteen patients treated with chemoradiotherapy (37.2%) and eight treated with bioradiotherapy (61.5%) had salvage surgery. Multivariate analysis showed that the variable most strongly related to salvage surgery after local recurrence of the tumor was the type of initial treatment. The frequency of postoperative complications was higher in patients who received chemoradiotherapy (62.5% versus 12.5%, P=0.03). Five-year adjusted-survival after salvage surgery was 26.0% for patients receiving chemoradiotherapy and 70.0% for patients undergoing bioradiotherapy (P=0.156).
Patients who presented recurrence after bioradiotherapy were more likely candidates to salvage surgery than those who had chemoradiotherapy. Patients undergoing salvage surgery had fewer postoperative complications and better adjusted survival after bioradiotherapy than after chemoradiotherapy.
分析晚期头颈部鳞状细胞癌放化疗或生物放疗后复发行挽救性手术后的肿瘤学结局及手术并发症。
2007年至2011年，187例患者接受了放化疗（n = 154）或生物放疗（n = 33）。接受生物放疗的患者年龄较大，总体状况有较差的趋势。随访期间，43例接受放化疗的患者（27.9%）和13例接受生物放疗的患者（39.3%）出现肿瘤局部复发。我们分析了适合挽救性手术的患者、这些手术的相关并发症及结局。
16例接受放化疗的患者（37.2%）和8例接受生物放疗的患者（61.5%）接受了挽救性手术。多因素分析显示，肿瘤局部复发后与挽救性手术最密切相关的变量是初始治疗类型。接受放化疗的患者术后并发症发生率较高（62.5%对12.5%，P = 0.03）。接受放化疗的患者挽救性手术后5年调整生存率为26.0%，接受生物放疗的患者为70.0%（P = 0.156）。
与接受放化疗后复发的患者相比，生物放疗后复发的患者更有可能接受挽救性手术。接受挽救性手术的患者术后并发症较少，生物放疗后的调整生存率优于放化疗后。
