口咽鳞状细胞癌治疗中期淋巴结反应的预后潜力
Prognostic potential of mid-treatment nodal response in oropharyngeal squamous cell carcinoma.
作者信息
Byun David J, Tam Moses M, Jacobson Adam S, Persky Mark S, Tran Theresa T, Givi Babak, DeLacure Mark D, Li Zujun, Harrison Louis B, Hu Kenneth S
机构信息
Department of Radiation Oncology, NYU Langone Health, New York, New York, USA.
Department of Otolaryngology, NYU Langone Health, New York, New York, USA.
出版信息
Head Neck. 2020 Sep 21. doi: 10.1002/hed.26467.
BACKGROUND
We examine the prognostic implications of mid-course nodal response in oropharyngeal cancer (OPX) to radiation therapy.
METHODS
In 44 patients with node-positive OPX undergoing concurrent chemoradiation, nodal volumes were measured on cone beam CTs from days 1, 10, 20, and 35. Nodal decrease (ND) was based on percent shrinkage from day 1.
RESULTS
At a median follow-up of 17 months, the 2-year disease-free survival (DFS), locoregional control (LRC), distant metastasis-free survival (DMFS), and overall survival (OS) were 87%, 92%, 89%, and 92%, respectively. Patients with ND ≥43% at D20 had improved LRC (100% vs 78.4%, P = .03) compared to D20 ND <43%. On multivariate analysis, D20 ≥43% was independently prognostic for LRC (HR 1.17, P = .05).
CONCLUSION
Patients with low-risk oropharynx cancer with ND of ≥43% by treatment day 20 had significantly improved LRC. The prognostic benefit of ND may assist in identifying candidates for treatment de-escalation.
背景
我们研究口咽癌（OPX）放疗过程中淋巴结中期反应的预后意义。
方法
44例接受同步放化疗的淋巴结阳性OPX患者，在第1、10、20和35天通过锥形束CT测量淋巴结体积。淋巴结缩小（ND）基于第1天的缩小百分比。
结果
中位随访17个月时，2年无病生存率（DFS）、局部区域控制率（LRC）、无远处转移生存率（DMFS）和总生存率（OS）分别为87%、92%、89%和92%。与第20天ND<43%的患者相比，第20天ND≥43%的患者LRC有所改善（100%对78.4%，P = 0.03）。多因素分析显示，第20天ND≥43%是LRC的独立预后因素（HR 1.17，P = 0.05）。
结论
到治疗第20天ND≥43%的低风险口咽癌患者LRC显著改善。ND的预后益处可能有助于识别治疗降级的候选者。
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