接受放射治疗的晚期头颈癌患者的流行病学因素。
Epidemiologic factors in patients with advanced head and neck cancer treated with radiation therapy.
作者信息
Brennan Michael T, Treister Nathaniel S, Sollecito Thomas P, Schmidt Brian L, Patton Lauren L, Yang Yi, Lin Alexander, Elting Linda S, Hodges James S, Lalla Rajesh V
机构信息
Department of Oral Medicine, Atrium Health's Carolinas Medical Center, Charlotte, North Carolina, USA.
Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, Boston, Massachusetts, USA.
出版信息
Head Neck. 2021 Jan;43(1):164-172. doi: 10.1002/hed.26468. Epub 2020 Sep 29.
BACKGROUND
Approximately 50% of patients with head and neck cancer (HNC) initially were seen with advanced disease. We aimed to evaluate the association of epidemiologic factors with advanced HNC at diagnosis.
METHODS
The OraRad multicenter prospective cohort study enrolled HNC patients receiving curative-intent radiation therapy. Factors assessed for association with advanced HNC presentation at diagnosis included demographics, social and medical history, cancer characteristics, human papilloma virus (HPV) status, and dental disease measures.
RESULTS
We enrolled 572 participants; 77% male and mean (SD) age of 61.7 (11.2) years. Oropharyngeal squamous cell carcinomas (88% HPV-related) were seen with smaller tumors, but more frequent nodal involvement. Private medical insurance and no Medicaid were associated with smaller tumors. A higher dental disease burden was associated with larger tumors.
CONCLUSIONS
Insurance status, cancer type/location, and dental disease are associated with advanced HNC and may represent potentially modifiable factors or factors to be considered in the screening process of new lesions.
背景
约50%的头颈癌（HNC）患者初诊时即已处于晚期。我们旨在评估流行病学因素与诊断时晚期头颈癌的相关性。
方法
OraRad多中心前瞻性队列研究纳入了接受根治性放疗的头颈癌患者。评估与诊断时晚期头颈癌表现相关的因素包括人口统计学、社会和病史、癌症特征、人乳头瘤病毒（HPV）状态以及牙科疾病指标。
结果
我们纳入了572名参与者；77%为男性，平均（标准差）年龄为61.7（11.2）岁。口咽鳞状细胞癌（88%与HPV相关）肿瘤较小，但淋巴结受累更常见。私人医疗保险且无医疗补助与较小的肿瘤相关。较高的牙科疾病负担与较大的肿瘤相关。
结论
保险状况、癌症类型/部位和牙科疾病与晚期头颈癌相关，可能代表在新病变筛查过程中潜在可改变的因素或需考虑的因素。
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