Spinato Giacomo, Stellin Marco, Azzarello Giuseppe, Bonazza Deborah, Zanconati Fabrizio, Politi Doriano, Cocuzza Salvatore, Di Mauro Paola, Ausoni Simonetta, Tonoli Giovanni, Costantini Giulio, Maiolino Luigi, Spinato Roberto, Da Mosto Maria Cristina, Baboci Lorena, Del Mistro Annarosa, Serra Agostino, Tirelli Giancarlo
Ear, Nose and Throat Department, Rovigo Provincial Hospital, I-45100 Rovigo, Italy.
Department of Neurosciences, Ear, Nose and Throat Clinic and Regional Center for Head and Neck Cancer, University of Padua, Treviso Provincial Hospital, I-35122 Padua, Italy.
Oncol Lett. 2017 Jul;14(1):185-193. doi: 10.3892/ol.2017.6152. Epub 2017 May 10.
The treatment of advanced-stage oropharyngeal squamous cell carcinoma may utilize various modes, including combining surgery with chemoradiotherapy (CTRT), or primary CTRT followed by rescue surgery. In previous literature it has been revealed how patients treated with combined modes report a low quality of life (QoL) and severe consequences following surgery, radiotherapy and chemotherapy, in the short and in the long-term. The decrease in the QoL of patients treated with high-intensity multi-modal strategies highlights the necessity of modifying treatments, particularly for young HPV-positive patients, where an increased survival rate has already been reported. The modified treatment for HPV-positive tumors in the tonsils and at the base of the tongue is based on the deintensification of therapies aiming to reduce toxicity and thereby improve QoL in the long term, whilst still maintaining therapeutic effectiveness. The aim of the present study was to evaluate the QoL in patients with a long-term survival, who were treated with combined therapy for squamous cell tumors in the tonsils and at the base of the tongue, and to compare the results observed in HPV-positive and HPV-negative patients. According to statistical analysis, differences in the general QoL and in the single scales of the European Organization for the Research and Treatment of Cancer questionnaires were not correlated with the type of therapy selected for the particular patient. QoL considered the presence of HPV, the type of treatment, the subregion of the tonsils vs. the base of the tongue and the disease stage at the time of diagnosis, and was determined to be non-influential with regard to these specific variables.
晚期口咽鳞状细胞癌的治疗可采用多种方式，包括手术联合放化疗（CTRT），或先进行初始CTRT，随后进行挽救性手术。以往文献显示，接受联合治疗方式的患者在短期和长期内，术后、放疗和化疗后生活质量（QoL）较低且有严重后果。高强度多模式治疗策略导致患者QoL下降，凸显了调整治疗方案的必要性，尤其是对于年轻的HPV阳性患者，已有报道其生存率有所提高。针对扁桃体和舌根处HPV阳性肿瘤的改良治疗基于治疗强度的降低，旨在减少毒性，从而长期改善QoL，同时仍保持治疗效果。本研究的目的是评估接受扁桃体和舌根鳞状细胞肿瘤联合治疗的长期存活患者的QoL，并比较HPV阳性和HPV阴性患者的观察结果。根据统计分析，癌症研究与治疗组织问卷的总体QoL及单个量表的差异与为特定患者选择的治疗类型无关。QoL考虑了HPV的存在、治疗类型、扁桃体与舌根的亚区域以及诊断时的疾病阶段，并且确定这些特定变量对其无影响。
