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比较机器人手术治疗口咽鳞状细胞癌后辅助治疗的全国实践与标准指南。

Comparing national practice versus standard guidelines for the use of adjuvant treatment following robotic surgery for oropharyngeal squamous cell carcinoma.

作者信息

Bates James E, Hitchcock Kathryn E, Mendenhall William M, Dziegielewski Peter T, Amdur Robert J

机构信息

Department of Radiation Oncology, University of Florida, College of Medicine, Gainesville, Florida, USA.

Department of Otolaryngology, University of Florida, College of Medicine, Gainesville, Florida, USA.

出版信息

Head Neck. 2020 Sep;42(9):2602-2606. doi: 10.1002/hed.26311. Epub 2020 Jun 1.

Abstract

BACKGROUND

Recent historical management of oropharyngeal squamous cell carcinoma typically includes radiotherapy with/without chemotherapy. Novel surgical techniques such as robotic surgery have made primary surgery more frequent; however, postoperative radiotherapy may be recommended. We aimed to assess adherence to guidelines for postoperative therapy following robotic surgery.

METHODS

Using the National Cancer Database, we analyzed the frequency of radiotherapy following robotic surgery for cT1-3cN0-2cM0 squamous cell carcinoma of the oropharynx, specifically in the presence of widely accepted indications for postoperative radiotherapy and/or chemotherapy.

RESULTS

Approximately two-thirds of patients received radiotherapy after robotic surgery for early-intermediate stage oropharyngeal cancer. One in five patients with an indication for adjuvant radiotherapy and 1/3 with an indication for adjuvant chemotherapy did not receive recommended adjuvant therapy.

CONCLUSIONS

A high proportion of patients require radiotherapy after robotic surgery for early-intermediate stage oropharyngeal cancer. Patients with an indication for further adjuvant therapy commonly do not receive it.

摘要

背景

口咽鳞状细胞癌近期的传统治疗通常包括放疗联合或不联合化疗。新型手术技术,如机器人手术,使一期手术更为常见;然而,术后放疗仍可能被推荐。我们旨在评估机器人手术后遵循术后治疗指南的情况。

方法

利用国家癌症数据库,我们分析了机器人手术治疗cT1-3cN0-2cM0口咽鳞状细胞癌后放疗的频率,特别是在存在广泛认可的术后放疗和/或化疗指征的情况下。

结果

约三分之二的患者在机器人手术后接受了早期-中期口咽癌放疗。五分之一有辅助放疗指征的患者和三分之一有辅助化疗指征的患者未接受推荐的辅助治疗。

结论

早期-中期口咽癌患者在机器人手术后有很大比例需要放疗。有进一步辅助治疗指征的患者通常未接受治疗。

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