Tao Hengmin, Shen Zhong, Liu Zhichao, Wei Yumei
Department of Head and Neck Radiotherapy, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China.
Key Laboratory of Otorhinolaryngology, National Health Commission (Shandong University), Jinan, People's Republic of China.
Cancer Manag Res. 2020 Aug 21;12:7553-7560. doi: 10.2147/CMAR.S249725. eCollection 2020.
To evaluate the feasibility and efficacy of low postoperative radiotherapy (PORT) dose in patients with advanced hypopharyngeal squamous cell carcinoma (HPSCC) and identify prognostic factors in this group.
Between January 2013 and September 2015, 110 consecutive patients with HPSCC with no high-risk factors were treated postoperatively to 50 Gy (n=89), 56 Gy (n=12), and 60 Gy (n=9) in 2 Gy/fraction. Overall survival (OS), 3-year progression-free survival (PFS), 3-year loco-regional recurrence-free survival (LRFS), and treatment-related toxicities were analyzed.
Median follow-up time was 40 months (range=6-75 months). The 3-year local-regional control (LRC) and 3-year neck control rate were 86.3% and 91.8%, respectively. The 3-year OS, PFS, and LRFS were 69.9%, 65.5%, and 80.5%, respectively. In a univariate analysis, T stage showed a significant correlation with improved OS, PFS, and LRFS (=0.008, =0.039, =0.034). On multivariate analysis, T stage showed a significant correlation with improved OS and PFS. N stage showed a significant correlation with improved PFS. However, interval surgery-radiotherapy, reconstructive methods, and RT dose cannot serve as a significant prognostic factor for survival outcome.
This study suggests that treating no high-risk factors for locally advanced HPSCC with a dose of 50 Gy to the whole operative bed and elective lymph node levels cannot compromise disease control and survival.
评估晚期下咽鳞状细胞癌（HPSCC）患者术后低剂量放疗（PORT）的可行性和疗效，并确定该组患者的预后因素。
2013年1月至2015年9月期间，110例无高危因素的连续性HPSCC患者术后接受放疗，每次分割剂量2 Gy，总剂量分别为50 Gy（n = 89）、56 Gy（n = 12）和60 Gy（n = 9）。分析总生存期（OS）、3年无进展生存期（PFS）、3年局部区域无复发生存期（LRFS）及治疗相关毒性。
中位随访时间为40个月（范围6 - 75个月）。3年局部区域控制率（LRC）和3年颈部控制率分别为86.3%和91.8%。3年OS、PFS和LRFS分别为69.9%、65.5%和80.5%。单因素分析中，T分期与OS、PFS和LRFS改善显著相关（P = 0.008、P = 0.039、P = 0.034）。多因素分析中，T分期与OS和PFS改善显著相关。N分期与PFS改善显著相关。然而，手术至放疗间隔时间、重建方法和放疗剂量不能作为生存结局的显著预后因素。
本研究表明，对局部晚期HPSCC无高危因素的患者，对整个手术床及选择性淋巴结区域给予50 Gy剂量放疗不会影响疾病控制和生存。
