复发性或第二原发头颈部癌再放疗的长期疗效：AIRO-Head and Neck 工作组的多机构研究。
Long-term outcome of re-irradiation for recurrent or second primary head and neck cancer: A multi-institutional study of AIRO-Head and Neck working group.
机构信息
Radiotherapy 1 Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
Radiotherapy 2 Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
出版信息
Head Neck. 2019 Oct;41(10):3684-3692. doi: 10.1002/hed.25890. Epub 2019 Jul 29.
BACKGROUND
To report the long-term outcome of patients undergoing re-irradiation (re-RT) for a recurrent or second primary head and neck cancer (RSPHNCs) in seven Italian tertiary centers, while testing the Multi-Institution Reirradation (MIRI) recursive partitioning analysis (RPA) recently published.
METHODS
We retrospectively analyzed 159 patients. Prognostic factors for overall survival (OS) selected by a random forest model were included in a multivariable Cox analysis. To externally validate MIRI RPA, we estimated the Kaplan-Meier group-stratified OS curves for the whole population.
RESULTS
Five-year OS was 43.5% (median follow-up: 49.9 months). Nasopharyngeal site, no organ dysfunction, and re-RT volume <36 cm were independent factors for better OS. By applying the MIRI RPA to our cohort, a Harrell C-Index of 0.526 was found indicating poor discriminative ability.
CONCLUSION
Our data reinforce the survival benefit of Re-RT for selected patients with RSPHNC. MIRI RPA was not validated in our population.
背景
报告 7 家意大利三级中心的复发性或第二原发头颈部癌症（RSPHNC）患者接受再放疗（re-RT）的长期结果，同时测试最近发表的多机构再放疗（MIRI）递归分区分析（RPA）。
方法
我们回顾性分析了 159 名患者。通过随机森林模型选择的总生存（OS）预后因素纳入多变量 Cox 分析。为了外部验证 MIRI RPA，我们估计了整个人群的 Kaplan-Meier 组分层 OS 曲线。
结果
5 年 OS 为 43.5%（中位随访：49.9 个月）。鼻咽部位、无器官功能障碍和 re-RT 体积<36cm 是 OS 更好的独立因素。将 MIRI RPA 应用于我们的队列，发现 Harrell C-指数为 0.526，表明区分能力差。
结论
我们的数据加强了 re-RT 对选定的 RSPHNC 患者的生存获益。MIRI RPA 在我们的人群中未得到验证。
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