中危口底癌术后放化疗的生存结果

Survival outcomes for postoperative chemoradiation in intermediate-risk oral tongue cancers.

作者信息

Spiotto Michael T, Jefferson Gina D, Wenig Barry, Markiewicz Michael R, Weichselbaum Ralph R, Koshy Matthew

机构信息

Department of Radiation and Cellular Oncology, University of Chicago Medical Center, Chicago, Illinois.

Department of Radiation Oncology, University of Illinois Hospital and Health Sciences System, Chicago, Illinois.

出版信息

Head Neck. 2017 Dec;39(12):2537-2548. doi: 10.1002/hed.24932. Epub 2017 Sep 27.

DOI:10.1002/hed.24932

PMID:28960621

Abstract

BACKGROUND

The survival outcomes for surgery + postoperative radiotherapy (S+RT) or surgery + postoperative chemoradiation (S+CRT) was compared in patients having oral tongue cancers with intermediate-risk pathological features.

METHODS

Using the National Cancer Database (NCDB), overall survival (OS) for S+RT or S+CRT was estimated using the Kaplan-Meier methods and Cox proportional hazard models in the entire population (n = 2803) and in a propensity-matched cohort (n = 1136).

RESULTS

The 3-year OS was 73.3% for S+CRT versus 66.7% for S+RT (P = .02). The S+CRT improved the 3-year OS for patients with 2 or more involved metastatic lymph nodes (≥2 MLNs; P = .01) but not for patients with <2 MLNs (P = .73). Undergoing S+CRT improved the 3-year OS for patients with pathologic T classification (pT) pT3-pT4 disease (P = .01) but not for patients with pT1-pT2 disease (P = .18).

CONCLUSION

Undergoing S+CRT was associated with improved survival for patients with tongue cancers with ≥2 MLNs and/or pT3-pT4 suggesting that specific intermediate-risk pathological features benefit from treatment intensification.

摘要

背景

对具有中度风险病理特征的口腔舌癌患者，比较手术 + 术后放疗（S+RT）或手术 + 术后放化疗（S+CRT）的生存结局。

方法

利用国家癌症数据库（NCDB），采用Kaplan-Meier法和Cox比例风险模型，在全部人群（n = 2803）和倾向评分匹配队列（n = 1136）中估计S+RT或S+CRT的总生存期（OS）。

结果

S+CRT组的3年总生存率为73.3%，而S+RT组为66.7%（P = .02）。S+CRT提高了有2个或更多受累转移淋巴结（≥2个MLN）患者的3年总生存率（P = .01），但对<2个MLN的患者没有改善（P = .73）。接受S+CRT提高了病理T分类（pT）为pT3 - pT4疾病患者的3年总生存率（P = .01），但对pT1 - pT2疾病患者没有改善（P = .18）。