Hirai Hideaki, Ohsako Toshimitsu, Kugimoto Takuma, Tomioka Hirofumi, Michi Yasuyuki, Kayamori Kou, Yoda Tetsuya, Miura Masahiko, Yoshimura Ryoichi, Harada Hiroyuki
Department of Oral and Maxillofacial Surgery, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan.
Department of Oral Pathology, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan.
Oral Oncol. 2020 Aug;107:104708. doi: 10.1016/j.oraloncology.2020.104708. Epub 2020 Apr 25.
In patients with advanced oral squamous cell carcinoma (OSCC), surgical treatment is often administered in combination with radiotherapy-based postoperative adjuvant therapy. The aim of the present study was to determine the most appropriate dose by comparing patient outcomes between doses of 50- and 66-Gy for postoperative cervical irradiation.
This retrospective study included patients who underwent postoperative cervical irradiation following neck dissection for OSCC with lymph nodes metastases, and their primary lesions were controlled. They were divided into the 50- and 66-Gy irradiation groups and were examined for sex, age, primary lesion site, tumor/node/metastasis stage, initial treatment for primary cancer, neck dissection procedure, number of metastatic lymph nodes, presence or absence of extranodal extension (ENE), concomitant anticancer agents, and therapeutic outcomes.
A total of 78 patients met the clinical criteria for study enrollment. The 50- and 66-Gy postoperative cervical irradiation groups included 40 and 38 patients, with neck dissection performed at 45 and 38 sites, respectively. Cervical control rate was 97.5% and 97.3% in the 50- and 66-Gy irradiation groups (p = 0.74). The cumulative disease-specific 5-year survival rate was 85.6% and 88.3%, respectively, with no significant difference (p = 0.64).
The findings of our study indicate that the irradiation dose of 50 Gy is appropriate for postoperative cervical irradiation in patients with OSCC.
在晚期口腔鳞状细胞癌（OSCC）患者中，手术治疗常与基于放疗的术后辅助治疗联合应用。本研究的目的是通过比较50 Gy和66 Gy剂量的术后颈部照射患者的预后，确定最合适的剂量。
本回顾性研究纳入了因OSCC伴淋巴结转移行颈清扫术后接受颈部照射的患者，其原发灶得到控制。他们被分为50 Gy和66 Gy照射组，并对性别、年龄、原发灶部位、肿瘤/淋巴结/转移分期、原发癌的初始治疗、颈清扫手术、转移淋巴结数量、有无结外侵犯（ENE）、同时使用的抗癌药物以及治疗结果进行了检查。
共有78例患者符合研究入组的临床标准。50 Gy和66 Gy术后颈部照射组分别包括40例和38例患者，颈清扫分别在45个和38个部位进行。50 Gy和66 Gy照射组的颈部控制率分别为97.5%和97.3%（p = 0.74）。累积疾病特异性5年生存率分别为85.6%和88.3%，无显著差异（p = 0.64）。
我们的研究结果表明，50 Gy的照射剂量适用于OSCC患者的术后颈部照射。
