Hall Stephen F, Griffiths Rebecca J, O'Sullivan Brian, Liu Fei-Fei
Department of Otolaryngology and Division of Cancer Care and Epidemiology of the Queen's Cancer Research Institute, Queen's University, Kingston, Ontario, Canada.
Cancer Care and Epidemiology at the Queen's Cancer Research Institute, Queen's University, Kingston, Ontario, Canada.
Head Neck. 2019 Jul;41(7):2271-2276. doi: 10.1002/hed.25679. Epub 2019 Feb 4.
Distant metastases (DM) are a leading cause of death for patients with oropharyngeal cancer (OPSCC). The objective of this study was to compare the rates of DM after chemoradiotherapy (CRT) and radiotherapy alone (RT) in patients with human papillomavirus (HPV)-positive and HPV-negative OPSCC.
In a retrospective population-based study of 525 patients across Ontario, Canada, in 1998/99/03/04, we compared treatment effectiveness using cumulative incidence function curves and cause-specific Cox regression models.
Sixty of 525 patients developed DM. There was no difference in rates (overall 10%-15%) between HPV-positive and HPV-negative patients or between CRT- and RT-treated patients. CRT reduced the risk of DM for the 15% of all HPV-positive patients with higher risk (T4 and/or N3) and not for HPV-negative patients (hazard ratio, 1.82 [0.65-5.07]).
The addition of platin-based chemotherapy to conventional RT did not decrease the rates of DM in the majority of patients with HPV-positive or in HPV-negative OPSSC.
远处转移（DM）是口咽癌（OPSCC）患者的主要死亡原因。本研究的目的是比较人乳头瘤病毒（HPV）阳性和HPV阴性口咽癌患者在接受放化疗（CRT）和单纯放疗（RT）后的远处转移率。
在一项基于人群的回顾性研究中，我们对1998/99/03/04年加拿大安大略省的525例患者进行了研究，使用累积发病率函数曲线和特定病因的Cox回归模型比较治疗效果。
525例患者中有60例发生远处转移。HPV阳性和HPV阴性患者之间或CRT和RT治疗患者之间的转移率没有差异（总体为10%-15%）。CRT降低了所有HPV阳性且风险较高（T4和/或N3）的15%患者的远处转移风险，但对HPV阴性患者没有效果（风险比，1.82 [0.65-5.07]）。
在传统放疗中添加铂类化疗并未降低大多数HPV阳性或HPV阴性口咽癌患者的远处转移率。
