Departments of Radiation Oncology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan.
Departments of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan.
BMC Cancer. 2020 Nov 26;20(1):1154. doi: 10.1186/s12885-020-07638-y.
We compared outcomes and toxicities between concurrent retrograde super-selective intra-arterial chemoradiotherapy (IACRT) and concurrent systemic chemoradiotherapy (SCRT) for gingival carcinoma (GC).
We included 84 consecutive patients who were treated for non-metastatic GC ≥ stage III, from 2006 to 2018, in this retrospective analysis (IACRT group: n = 66; SCRT group: n = 18).
The median follow-up time was 24 (range: 1-124) months. The median prescribed dose was 60 (6-70.2) Gy (IACRT: 60 Gy; SCRT: 69 Gy). There were significant differences between the two groups in terms of 3-year overall survival (OS; IACRT: 78.8, 95% confidence interval [CI]: 66.0-87.6; SCRT: 50.4, 95% CI: 27.6-73.0; P = 0.039), progression-free survival (PFS; IACRT: 75.6, 95% CI: 62.7-85.2; SCRT: 42.0, 95% CI: 17.7-70.9; P = 0.028) and local control rates (LC; IACRT: 77.2, 95% CI: 64.2-86.4; SCRT: 42.0, 95% CI: 17.7-70.9; P = 0.015). In univariate analysis, age ≥ 65 years, decreased performance status (PS) and SCRT were significantly associated with worse outcomes (P < 0.05). In multivariate analysis, age ≥ 65 years, clinical stage IV, and SCRT were significantly correlated with a poor OS rate (P < 0.05). Patients with poorer PS had a significantly worse PFS rate. Regarding acute toxicity, 22 IACRT patients had grade 4 lymphopenia, and osteoradionecrosis was the most common late toxicity in both groups.
This is the first report to compare outcomes from IACRT and SCRT among patients with GC. ALL therapy related toxicities were manageable. IACRT is an effective and safe treatment for GC.
我们比较了同期逆行超选择性动脉内化疗放疗（IACRT）与同期全身化疗放疗（SCRT）治疗牙龈癌（GC）的疗效和毒性。
我们回顾性分析了 2006 年至 2018 年期间治疗非转移性 GC≥III 期的 84 例连续患者（IACRT 组：n=66；SCRT 组：n=18）。
中位随访时间为 24 个月（范围：1-124）。中位规定剂量为 60Gy（IACRT：60Gy；SCRT：69Gy）。两组在 3 年总生存率（OS；IACRT：78.8%，95%置信区间[CI]：66.0-87.6；SCRT：50.4%，95%CI：27.6-73.0；P=0.039）、无进展生存率（PFS；IACRT：75.6%，95%CI：62.7-85.2；SCRT：42.0%，95%CI：17.7-70.9；P=0.028）和局部控制率（LC；IACRT：77.2%，95%CI：64.2-86.4；SCRT：42.0%，95%CI：17.7-70.9；P=0.015）方面存在显著差异。单因素分析显示，年龄≥65 岁、体力状态（PS）下降和 SCRT 与预后不良显著相关（P<0.05）。多因素分析显示，年龄≥65 岁、临床分期 IV 期和 SCRT 与 OS 率差显著相关（P<0.05）。PS 较差的患者 PFS 率显著较差。急性毒性方面，22 例 IACRT 患者出现 4 级淋巴细胞减少症，两组中最常见的迟发性毒性是放射性骨坏死。
这是首次比较 IACRT 和 SCRT 治疗 GC 患者疗效的报告。ALL 治疗相关毒性是可管理的。IACRT 是治疗 GC 的一种有效且安全的治疗方法。
