Clinical Cooperation Group 'Personalized Radiotherapy in Head and Neck Cancer', Helmholtz Zentrum München, German Research Center for Environmental Health GmbH, Ingolstädter Landstraße 1, 85764, Neuherberg, Germany.
Department of Radiation Oncology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany.
Radiat Oncol. 2018 Jul 3;13(1):123. doi: 10.1186/s13014-018-1067-1.
Postoperative (chemo) radiation improves tumor control and survival in high-risk patients with head and neck squamous cell carcinoma based on established risk factors. The clinical cooperation group "Personalized Radiotherapy in Head and Neck Cancer" focuses on the identification and validation of new biomarkers, which are aimed at eventually stratifying and personalizing the therapy concept. Hence, we reviewed all patients with head and neck squamous cell carcinoma of the oral cavity, oropharynx, hypopharynx, or larynx, treated with postoperative (chemo) radiation from 06/2008 until 06/2015 at the Department of Radiation Oncology in the University Hospital, LMU Munich. Here we report the clinical results of the cohort, laying the foundation for further research within the framework of a clinical cooperation group.
Patient data were retrospectively (until 2013) and prospectively (from 2013) collected and analyzed for outcome and treatment failures with regard to previously described and established risk factors.
We identified 302 patients (median follow-up 45 months, average age 60.7 years), having received postoperative (chemo)radiation (median 64 Gy). Chemotherapy was added in 58% of cases, mostly Cisplatin/5- Fluorouracil in concordance with the ARO 96-3 study. The 3-year overall survival, local, locoregional and distant failure estimates were 70.5, 9.7, 12.2 and 13.5%, respectively. Human papillomavirus-associated oropharyngeal cancer was associated with a significant improved overall survival, locoregional, distant and overall tumor control rates in multivariate analysis. Additionally, in multivariate analysis, for local failure, resection status and perineural invasion, for locoregional and distant failure extracapsular extension and for overall survival the presence of nodal disease were significant adverse factors. Moreover, 138 patients have been treated in concordance with the ARO 96-3 protocol, corroborating the results of this study.
Our cohort represents a large unselected cohort of patients with head and neck squamous cell carcinoma treated with postoperative (chemo)radiation. Tumor control rates and survival rates are consistent with the results of previously reported data.
基于已确定的风险因素，术后（化疗）放疗可提高头颈部鳞状细胞癌高危患者的肿瘤控制率和生存率。临床合作组“头颈部癌症个体化放疗”专注于识别和验证新的生物标志物，旨在最终对治疗方案进行分层和个体化。因此，我们回顾了 2008 年 6 月至 2015 年 6 月在慕尼黑大学医院放射肿瘤科接受术后（化疗）放疗的口腔、口咽、下咽或喉的头颈部鳞状细胞癌所有患者。在此，我们报告了该队列的临床结果，为在临床合作组框架内开展进一步研究奠定了基础。
回顾性（截至 2013 年）和前瞻性（自 2013 年起）收集患者数据，并根据先前描述和确定的风险因素分析结局和治疗失败。
我们共纳入 302 例患者（中位随访时间为 45 个月，平均年龄为 60.7 岁），接受了术后（化疗）放疗（中位剂量 64Gy）。58%的患者接受了化疗，主要是顺铂/5-氟尿嘧啶，符合 ARO 96-3 研究。3 年总生存率、局部、局部区域和远处失败率分别为 70.5%、9.7%、12.2%和 13.5%。人乳头瘤病毒相关性口咽癌在多变量分析中与总生存率、局部区域、远处和总肿瘤控制率的显著提高相关。此外，在多变量分析中，局部失败与手术切缘状态和神经周围侵犯、局部区域和远处失败与包膜外扩展、总生存率与淋巴结疾病有关，均为显著不良因素。此外，还有 138 例患者按照 ARO 96-3 方案进行治疗，证实了本研究的结果。
我们的队列代表了一组未经选择的接受术后（化疗）放疗的头颈部鳞状细胞癌患者，肿瘤控制率和生存率与之前报道的数据一致。
