使用预定义治疗策略对ICON-S分期系统用于人乳头瘤病毒相关口咽癌的验证。
Validation of the ICON-S staging for HPV-associated oropharyngeal carcinoma using a pre-defined treatment policy.
作者信息
Porceddu Sandro V, Milne Rob, Brown Elizabeth, Bernard Anne, Rahbari Reza, Cartmill Bena, Foote Matthew, McGrath Margaret, Coward Jermaine, Panizza Benedict
机构信息
Department of Cancer Services, Princess Alexandra Hospital, Brisbane, Queensland, Australia; Faculty of Medicine, University of Queensland, Queensland, Australia.
Faculty of Medicine, University of Queensland, Queensland, Australia.
出版信息
Oral Oncol. 2017 Mar;66:81-86. doi: 10.1016/j.oraloncology.2017.01.002. Epub 2017 Jan 21.
OBJECTIVES
To determine whether the International Collaboration on Oropharyngeal cancer Network for Staging (ICON-S) for HPV associated oropharyngeal carcinoma (HPV+OPC) is a better discriminator of overall survival (OS), compared with the 7th edition (7th Ed) AJCC/UICC TNM staging following curative radiotherapy (RT).
MATERIAL AND METHODS
The 5-year OS for all patients with non-metastatic (M0) p16-confirmed OPC treated between 2005 and 2015 was determined and grouped based on the 7th Ed AJCC/UICC TNM and ICON-S staging.
RESULTS
A total of 279 patients met the inclusion criteria. The 5-year OS with the 7th Ed TNM classification were Stage I/II 88.9% (95% CI; 70.6-100%), Stage III 93.8% (95% CI; 85.9-100%), Stage IVa 86.4% (95% CI; 81.6-91.5%) and Stage IVb 62.3% (95% CI; 46.8-82.8%). On multivariate Cox regression analysis there was no statistically significant OS difference when comparing Stage I/II with, Stage III (p=0.98, HR=0.97, 95% CI; 0.11-8.64), IVa (p=0.67, HR=1.56, 95% CI; 0.2-11.94) and IVb (p=0.11, HR=5.54, 95% CI; 0.69-44.52), respectively. The 5-year OS with ICON-S staging were Stage I 93.6% (95% CI; 89.4-98.0%), Stage II 81.9% (95% CI; 73.7-91.1%) and Stage III 69.1% (95%; 57.9-82.6%). There was a consistent decrease of OS with increasing stage. On multivariate Cox regression analysis, when compared to Stage I, OS was significantly lower for stage II (p=0.007, HR=2.84, 95% CI; 1.33-6.05) and stage III (p<0.001, HR=3.78, 95% CI; 1.81-7.92), respectively.
CONCLUSION
The ICON-S staging provides better OS stratification for HPV+OPC following RT compared with the 7th Ed TNM staging.
目的
确定与第7版美国癌症联合委员会（AJCC）/国际抗癌联盟（UICC）TNM分期相比，口咽癌HPV相关口咽癌（HPV+OPC）国际分期协作网络（ICON-S）分期在根治性放疗（RT）后对总生存期（OS）是否具有更好的区分能力。
材料与方法
确定2005年至2015年间接受治疗的所有非转移性（M0）p16确诊OPC患者的5年总生存期，并根据第7版AJCC/UICC TNM和ICON-S分期进行分组。
结果
共有279例患者符合纳入标准。第7版TNM分期的5年总生存期为：I/II期88.9%（95%CI；70.6-100%），III期93.8%（95%CI；85.9-100%），IVa期86.4%（95%CI；81.6-91.5%），IVb期62.3%（95%CI；46.8-82.8%）。多因素Cox回归分析显示，将I/II期与III期（p=0.98，HR=0.97，95%CI；0.11-8.64）、IVa期（p=0.67，HR=1.56，95%CI；0.2-11.94）和IVb期（p=0.11，HR=5.54，95%CI；0.69-44.52）分别比较时，总生存期无统计学显著差异。ICON-S分期的5年总生存期为：I期93.6%（95%CI；89.4-98.0%），II期81.9%（95%CI；73.7-91.1%），III期69.1%（95%；57.9-82.6%）。总生存期随分期增加而持续下降。多因素Cox回归分析显示，与I期相比，II期（p=0.007，HR=2.84，95%CI；1.33-6.05）和III期（p<0.001，HR=3.78，95%CI；1.81-7.92）的总生存期显著更低。
结论
与第7版TNM分期相比，ICON-S分期在RT后为HPV+OPC提供了更好的总生存期分层。
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