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新辅助化疗与经口手术作为口咽癌的确定性治疗方法:一种可行的新方法。

Neoadjuvant chemotherapy and transoral surgery as a definitive treatment for oropharyngeal cancer: A feasible novel approach.

作者信息

Sadeghi Nader, Li Ning-Wei, Taheri M Reza, Easley Samantha, Siegel Robert S

机构信息

Division of Otolaryngology - Head and Neck Surgery, George Washington University, Washington, DC.

Department of Radiology, George Washington University, Washington, DC.

出版信息

Head Neck. 2016 Dec;38(12):1837-1846. doi: 10.1002/hed.24526. Epub 2016 Jun 14.

Abstract

BACKGROUND

The purpose of this study was to present our evaluation of the outcome of oropharyngeal cancer managed with neoadjuvant chemotherapy and transoral surgery (TOS) with neck dissection as definitive treatment.

METHODS

This is a case series of 17 patients with advanced oropharyngeal cancer who were treated with neoadjuvant chemotherapy followed by TOS. The treatment details and oncologic outcome are reported. The volumetric response of the tumor to neoadjuvant chemotherapy is evaluated and validated by histopathology.

RESULTS

Seventeen patients with TNM stages III and IV oropharyngeal cancer constitute this series for survival analysis. On a median and mean follow-up of 31 and 40 months, respectively, 16 of the 17 patients were alive without recurrence. Disease-specific survival (DSS) and overall survival (OS) at 3 years were 94.1%.

CONCLUSION

Adjuvant chemotherapy followed by TOS and neck dissection is a feasible and efficacious novel therapeutic approach for definitive management of moderately advanced oropharyngeal cancer, reserving radiotherapy (RT) for salvage or adverse features. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1837-1846, 2016.

摘要

背景

本研究的目的是展示我们对采用新辅助化疗和经口手术(TOS)并进行颈部清扫作为确定性治疗的口咽癌治疗结果的评估。

方法

这是一组17例晚期口咽癌患者的病例系列,他们接受了新辅助化疗,随后进行了经口手术。报告了治疗细节和肿瘤学结果。通过组织病理学评估并验证了肿瘤对新辅助化疗的体积反应。

结果

17例TNM分期为III期和IV期的口咽癌患者构成了本生存分析系列。中位随访时间和平均随访时间分别为31个月和40个月,17例患者中有16例存活且无复发。3年时的疾病特异性生存率(DSS)和总生存率(OS)为94.1%。

结论

新辅助化疗后进行经口手术和颈部清扫是一种可行且有效的新型治疗方法,用于确定性治疗中度晚期口咽癌,将放疗(RT)留作挽救性治疗或用于处理不良特征。© 2016威利期刊公司。《头颈外科》2016年第38卷:1837 - 1846页。

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