Kanakamedala Madhava R, Giri Shankar P G, Hamilton Robert D, Bhanat Eldrin, Vijayakumar Srinivasan
Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, Mississippi.
Head Neck. 2018 May;40(5):1034-1039. doi: 10.1002/hed.25077. Epub 2018 Jan 31.
The purpose of this study was to present the outcomes of oropharyngeal cancers treated with intensity-modulated radiotherapy (IMRT) especially the differences between tonsillar and base of tongue (BOT) primaries.
Retrospective analysis of 124 patients with biopsy proven squamous cell carcinomas of the oropharynx, treated with IMRT.
Human papillomavirus (HPV) association correlated with improvement in survivals in both tonsillar and BOT primaries. At the 2-year median follow-up, the cumulative incidences of locoregional recurrences were 8% in both the tonsil and BOT groups (P = .76) but the distant metastases were 8% in the tonsil group versus 26% in the BOT group (P = .009). Thirty percent of tonsil primaries has ≥N2c neck disease as compared to 54% of BOT. Incidence of distant metastases increases with advanced nodal classification, especially >N2c.
Even though the locoregional controls are excellent with IMRT and chemotherapy, these patients continue to fail distantly, particularly significant for the BOT group and for nodal stage >N2c.
本研究旨在呈现采用调强放疗（IMRT）治疗口咽癌的结果，尤其是扁桃体原发癌和舌根（BOT）原发癌之间的差异。
对124例经活检证实为口咽鳞状细胞癌并接受IMRT治疗的患者进行回顾性分析。
人乳头瘤病毒（HPV）相关性与扁桃体和BOT原发癌患者生存率的提高相关。在2年的中位随访期，扁桃体组和BOT组的局部区域复发累积发生率均为8%（P = 0.76），但扁桃体组远处转移率为8%，而BOT组为26%（P = 0.009）。30%的扁桃体原发癌患者颈部疾病≥N2c期，而BOT原发癌患者为54%。远处转移发生率随淋巴结分期进展而增加，尤其是>N2c期。
尽管IMRT联合化疗对局部区域控制效果良好，但这些患者仍会出现远处转移失败，对BOT组和淋巴结分期>N2c期患者尤为显著。
