辅助放疗在手术治疗的T1-2 N1口咽鳞状细胞癌中的益处
The Benefit of Adjuvant Radiation in Surgically-Treated T1-2 N1 Oropharyngeal Squamous Cell Carcinoma.
作者信息
Monroe Marcus M, Buchmann Luke O, Hunt Jason P, Hitchcock Ying J, Lloyd Shane, Hashibe Mia
机构信息
Departments of Otolaryngology-Head and Neck Surgery, University of Utah School of Medicine Salt Lake City Utah U.S.A.
Huntsman Cancer Institute, University of Utah School of Medicine Salt Lake City Utah U.S.A.
出版信息
Laryngoscope Investig Otolaryngol. 2017 Feb 2;2(2):57-62. doi: 10.1002/lio2.64. eCollection 2017 Apr.
IMPORTANCE
The benefit of adjuvant radiation in surgically treated T1-2N1 oropharyngeal cancer without adverse pathologic features remains unclear.
OBJECTIVES
To compare population-level survival outcomes in surgically-treated T1-2N1 oropharyngeal squamous cell carcinoma (OPSCC) with and without the use of adjuvant radiation.
STUDY DESIGN
Retrospective population-based study using the Surveillance, Epidemiology, and End Results (SEER) registry data from 1998-2011.
SETTING
Population-level study.
PARTICIPANTS
Patients with T1-2N1 OPSCC treated with surgical resection and neck dissection with or without adjuvant radiation.
INTERVENTIONS FOR CLINICAL TRIALS OR EXPOSURES FOR OBSERVATIONAL STUDIES
The use of postoperative adjuvant radiation.
MAIN OUTCOMES AND MEASURES
Overall and disease-specific survival.
RESULTS
Radiation was utilized in 74% of patients and was positively associated with extracapsular extension and well-differentiated histology. The use of radiation was associated with improved mean overall survival (124 v. 108 months, p=0.023) and a non-significant increase in mean disease-specific survival (138 v. 131 months, p=0.053).
CONCLUSIONS AND RELEVANCE
The use of adjuvant radiation is associated with improved survival in surgically-treated T1-2N1 squamous cell carcinoma of the oropharynx with unknown HPV status.
LEVEL OF EVIDENCE
IV.
重要性
辅助放疗对于手术治疗的无不良病理特征的T1-2N1口咽癌的益处仍不明确。
目的
比较接受手术治疗的T1-2N1口咽鳞状细胞癌（OPSCC）患者使用和不使用辅助放疗的人群水平生存结果。
研究设计
基于监测、流行病学和最终结果（SEER）登记处1998 - 2011年数据的回顾性人群研究。
研究地点
人群水平研究。
参与者
接受手术切除和颈部清扫且使用或不使用辅助放疗的T1-2N1 OPSCC患者。
临床试验的干预措施或观察性研究的暴露因素
术后辅助放疗的使用。
主要结局和测量指标
总生存率和疾病特异性生存率。
结果
74%的患者使用了放疗，放疗与包膜外扩展和高分化组织学呈正相关。放疗的使用与平均总生存率提高（124对108个月，p = 0.023）以及平均疾病特异性生存率非显著性增加（138对131个月，p = 0.053）相关。
结论和相关性
对于HPV状态未知的手术治疗的T1-2N1口咽鳞状细胞癌，辅助放疗的使用与生存率提高相关。
证据级别
IV级。
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