Graduate Institute of Clinical Medical Science, College of Medicine, Chang Gang University, Taoyuan, Taiwan.
Telehealth Telecare Center, Taipei Medical University Hospital, Taipei, Taiwan.
Head Neck. 2021 Apr;43(4):1142-1152. doi: 10.1002/hed.26575. Epub 2020 Dec 12.
No evidence is currently available to estimate the outcomes of intensity-modulated radiation therapy (IMRT) and surgery for patients with early oral cavity squamous cell carcinoma (E-OCSCC).
We recruited patients from the Taiwan Cancer Registry Database who had received a diagnosis of E-OCSCC. Propensity score matching was performed, and Cox proportional hazards model was used to analyze all-cause mortality.
In the multivariate Cox regression analyses, the adjusted hazard ratio (aHR) (95% confidence interval [CI]) for surgery compared with definitive IMRT, T2N0M0 compared with T1N0M0, and male patients compared with female patients were 0.303 (0.245, 0.375), 1.340 (1.077, 1.668), and 2.012 (1.432, 2.826), respectively. The aHRs (95% CIs) for age 61 to 70, 71 to 80, and ≧81 years compared with <40 years were 2.984 (1.43, 4.225), 3.353 (2.578, 4.112), and 4.277 (4.104, 5.679), respectively.
For patients with E-OCSCC, surgery may be considered the first option rather than definitive IMRT.
目前尚无证据可用于评估调强放疗（IMRT）和手术治疗早期口腔鳞状细胞癌（E-OCSCC）患者的疗效。
我们从台湾癌症登记数据库中招募了患有 E-OCSCC 的患者。采用倾向评分匹配法，并使用 Cox 比例风险模型分析全因死亡率。
在多变量 Cox 回归分析中，与根治性 IMRT 相比，手术的调整后危险比（aHR）（95%置信区间[CI]）为 0.303（0.245，0.375）；与 T1N0M0 相比，T2N0M0 的 aHR（95%CI）为 1.340（1.077，1.668）；与女性患者相比，男性患者的 aHR（95%CI）为 2.012（1.432，2.826）。与<40 岁相比，年龄为 61 至 70 岁、71 至 80 岁和≧81 岁的患者的 aHR（95%CI）分别为 2.984（1.43，4.225）、3.353（2.578，4.112）和 4.277（4.104，5.679）。
对于 E-OCSCC 患者，手术可能是首选治疗方法，而非根治性 IMRT。
