Chevalier Cédric, Bertaut Aurélie, Quivrin Magali, Vulquin Noémie, Desandes Cédric, Folia Mireille, Duvillard Christian, Truc Gilles, Crehange Gilles, Maingon Philippe
Department of Radiation Oncology, Georges François Leclerc Cancer Center, Dijon, France.
Department of Statistics, Georges François Leclerc Cancer Center, Dijon, France.
Clin Transl Radiat Oncol. 2016 Dec 21;1:27-32. doi: 10.1016/j.ctro.2016.11.002. eCollection 2016 Dec.
To evaluate the influence of delays for radiotherapy on survival, recurrence and upstaging for head and neck squamous-cell carcinoma (HNSCC) with no nodal involvement treated with intensity modulated radiotherapy (IMRT).
This retrospective study included 63 consecutive patients with HNSCC located in the pharynx and larynx and treated with exclusive IMRT with or without chemotherapy. Survival, loco-regional or distant failure and upstaging were analyzed according to the waiting time.
Mean waiting time for treatment was 62.5 days for the hypopharynx subgroup (range = 37-102), 63 days for the larynx subgroup (range = 19-128) and 58.5 days for the oropharynx subgroup (range = 29-99) ( = 0.725). Nine patients (14%) experienced upstaging. Loco-regional or distant failure occurred in 18 patients. Beyond a delay of 50 days, 19% of patients had local failure, 17% nodal recurrence and 11% distant failure. Within a delay of 50 days, no nodal or distant failure was observed and only 1 patient experienced local recurrence. Upstaging and overall survival were not significantly affected by an increased waiting time.
For N0 patients treated with IMRT for HNSCC, waiting time around 50 days after the diagnosis was not significantly associated with an excessive risk of upstaging or recurrence.
评估对头颈部无淋巴结转移的鳞状细胞癌（HNSCC）进行调强放射治疗（IMRT）时，放疗延迟对生存、复发及分期上调的影响。
这项回顾性研究纳入了63例连续的位于咽和喉的HNSCC患者，这些患者接受了单纯IMRT治疗，部分患者接受了化疗。根据等待时间分析生存、局部区域或远处失败以及分期上调情况。
下咽亚组的平均治疗等待时间为62.5天（范围=37 - 102天），喉亚组为63天（范围=19 - 128天），口咽亚组为58.5天（范围=29 - 99天）（P = 0.725）。9例患者（14%）出现分期上调。18例患者发生局部区域或远处失败。延迟超过50天时，19%的患者出现局部失败，17%出现淋巴结复发，11%出现远处失败。在延迟50天内，未观察到淋巴结或远处失败，仅有1例患者出现局部复发。分期上调和总生存未受到等待时间增加的显著影响。
对于接受IMRT治疗的HNSCC N0患者，诊断后约50天的等待时间与分期上调或复发的过高风险无显著关联。
