Departments of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Oral Oncol. 2021 Feb;113:105125. doi: 10.1016/j.oraloncology.2020.105125. Epub 2020 Dec 22.
HPV-positive oropharyngeal squamous cell carcinoma (OPSCC) carries a favorable prognosis for patients, yet nearly 30% of patients will experience disease relapse. We sought to detail patterns of failure, associated salvage therapy, and outcomes for patients with recurrent HPV-positive OPSCC.
This is a single institution retrospective study of patients with recurrent HPV-positive OPSCC irradiated from 2002 to 2014. The primary study outcome was overall survival (OS, calculated using the Kaplan-Meier method). Secondary aims included patterns of first failure with descriptive details of salvage therapy. Solitary recurrences were defined as initial presentation of recurrence in a single site (primary, neck or oligometastatic), and multi-site was defined as local and regional and/or multiple sites of distant recurrence. Survival outcomes were compared using the log-rank test.
The cohort consisted of 132 patients. The median follow-up was 59 months for surviving patients. Estimated 2-year and 5-year OS rates were 47% and 32%, respectively. Comparative 2-year and 5-year OS rates were 65% and 46% versus 19% and 9% for the solitary group and multi-site group, respectively (p < .001).
Patients with recurrent HPV-positive OPSCC experience 5-year survival of approximately 32%. However, patients with a "solitary" recurrence including disease at the primary site, neck or oligometastatic site have more favorable long-term outcomes.
HPV 阳性口咽鳞状细胞癌（OPSCC）患者预后良好，但仍有近 30%的患者会出现疾病复发。我们旨在详细描述 HPV 阳性 OPSCC 复发性疾病的失败模式、相关挽救治疗及结局。
这是一项对 2002 年至 2014 年期间接受放疗的 HPV 阳性 OPSCC 复发患者进行的单机构回顾性研究。主要研究结局为总生存（OS，通过 Kaplan-Meier 法计算）。次要目的包括首次失败模式，并详细描述挽救治疗情况。单发复发定义为初始复发仅在单一部位（原发部位、颈部或寡转移部位），多发复发定义为局部和区域及/或多处远处复发。采用对数秩检验比较生存结果。
该队列包括 132 例患者。存活患者的中位随访时间为 59 个月。估计 2 年和 5 年 OS 率分别为 47%和 32%。2 年和 5 年 OS 率分别为 65%和 46%，而单发组和多发组分别为 19%和 9%（p<.001）。
HPV 阳性 OPSCC 复发性患者 5 年生存率约为 32%。然而，“单发”复发（包括原发部位、颈部或寡转移部位）的患者具有更有利的长期结局。
