De Felice Francesca, Blanchard Pierre, Levy Antonin, Nguyen France, Gorphe Philippe, Janot François, Temam Stéphane, Tao Yungan
Department of Radiation Oncology, Gustave Roussy, Villejuif, France.
Department of Radiotherapy, Policlinico Umberto I "Sapienza" University of Rome, Rome, Italy.
Head Neck. 2016 Apr;38 Suppl 1:E1722-9. doi: 10.1002/hed.24307. Epub 2015 Nov 28.
Treatment strategy in squamous cell carcinoma (SCC) of the posterior pharyngeal wall is still being debated.
We performed a retrospective analysis according to delivered treatment.
One hundred eighty patients were treated between 1997 and 2011. Eighty-nine patients (49.4%) received surgery +/- radiotherapy (RT), whereas 91 (50.6%) received definitive RT +/- chemoradiotherapy (RT/CRT). Five-year overall survival (OS) was 33.4%. There was a significant 5-year OS benefit in surgical treatment versus RT/CRT (43% vs 24.1%; p = .002). Multivariate analysis showed that current smokers, T3 to T4 classification, well-differentiated SCC, and nonsurgical treatment were associated with reduced OS. Subgroup analysis showed significant survival benefit of surgical treatment compared with RT/CRT in patients with T1 to T2 but not in T3 to T4 disease.
Surgical management translated into a survival benefit, even in early T classification. These results should be interpreted with caution for selection bias. Surgery remains the standard of care in localized posterior pharyngeal wall SCC. Primary CRT should be considered for nonoperable disease. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1722-E1729.
下咽后壁鳞状细胞癌（SCC）的治疗策略仍存在争议。
我们根据所采用的治疗方法进行了回顾性分析。
1997年至2011年间共治疗了180例患者。89例（49.4%）接受了手术±放疗（RT），而91例（50.6%）接受了根治性放疗±放化疗（RT/CRT）。5年总生存率（OS）为33.4%。手术治疗与RT/CRT相比，5年OS有显著获益（43%对24.1%；p = 0.002）。多因素分析显示，当前吸烟者、T3至T4分期、高分化SCC和非手术治疗与OS降低相关。亚组分析显示，T1至T2期患者手术治疗与RT/CRT相比有显著生存获益，而T3至T4期患者则无。
即使在早期T分期，手术治疗也能带来生存获益。由于存在选择偏倚，这些结果应谨慎解读。手术仍然是局限性下咽后壁SCC的标准治疗方法。对于不可手术的疾病，应考虑采用根治性放化疗。© 2015威利期刊公司。头颈外科38: E1722 - E1729。
