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术后颈部放疗对pN0期口腔舌癌患者区域控制的疗效:倾向分析

Efficacy of postoperative neck irradiation for regional control in patients with pN0 oral tongue cancer: Propensity analysis.

作者信息

So Yoon Kyoung, Oh Dongryul, Choi Nayeon, Baek Chung-Hwan, Ahn Yong Chan, Chung Man Ki

机构信息

Department of Otorhinolaryngology - Head and Neck Surgery, Inje University College of Medicine, Ilsan Paik Hospital, Goyang-Si, Korea.

Department of Radiation Oncology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea.

出版信息

Head Neck. 2018 Jan;40(1):163-169. doi: 10.1002/hed.24980. Epub 2017 Oct 30.

Abstract

BACKGROUND

The purpose of this study was to investigate whether adjuvant radiotherapy (RT) is efficacious for regional control and survival in patients with pN0 oral tongue cancer.

METHODS

Clinicopathological features of 166 patients with pN0 oral tongue cancer were compared between those who underwent adjuvant RT to the neck (neck RT-positive) and those who did not (neck RT-negative). Study endpoints were isolated regional recurrence and 3-year regional recurrence-free survival (RRFS). Propensity score matching was also performed.

RESULTS

Cox regression analysis did not reveal any significant predictor of isolated regional recurrence, including RT field. Three-year RRFS showed modest improvement in neck RT-positive group compared to neck RT-negative group before (92.2% vs 91.9%) and after propensity analysis (93.8% vs 83.3%), without statistical significance (log-rank P = .85 and .37, respectively).

CONCLUSION

Despite more frequent unfavorable factors, the neck RT-positive group had a comparable oncologic outcome to the neck RT-negative group, suggesting that a marginal benefit in regional control might be expected from extending the RT field to the neck for pN0 oral tongue cancer.

摘要

背景

本研究旨在调查辅助放疗(RT)对pN0期口腔舌癌患者的区域控制和生存是否有效。

方法

比较了166例pN0期口腔舌癌患者中接受颈部辅助放疗者(颈部放疗阳性)和未接受者(颈部放疗阴性)的临床病理特征。研究终点为孤立区域复发和3年区域无复发生存率(RRFS)。还进行了倾向评分匹配。

结果

Cox回归分析未发现包括放疗野在内的任何孤立区域复发的显著预测因素。在倾向分析之前(92.2%对91.9%)和之后(93.8%对83.3%),颈部放疗阳性组的3年RRFS与颈部放疗阴性组相比有适度改善,但无统计学意义(对数秩检验P分别为0.85和0.37)。

结论

尽管颈部放疗阳性组的不良因素更常见,但其肿瘤学结局与颈部放疗阴性组相当,这表明对于pN0期口腔舌癌,将放疗野扩展至颈部可能在区域控制方面带来微小益处。

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