Miyamaru Satoru, Murakami Daizo, Nishimoto Kohei, Saito Haruki, Miyamoto Yusuke, Hirota Kaoruko, Ise Momoko, Orita Yorihisa
Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kumamoto University.
Acta Med Okayama. 2021 Feb;75(1):31-37. doi: 10.18926/AMO/61431.
Although the lung is the most common site of distant metastases from head and neck squamous cell carcinoma (HNSCC), the number of reports about the effects of pulmonary metastasectomy for the treatment of lung metastasis from HNSCC is limited. Metachronous pulmonary metastases were detected in 45 HNSCC patients at Kumamoto University Hospital from 1998 to 2018. Twenty-two patients underwent an operative resection (Ope group) and 23 underwent chemotherapy (Chemo group). The 3-year overall survival (OS) rate and median OS were evaluated. The effects of adjuvant chemotherapy after pulmonary metastasectomy and of new drugs (cetuximab and nivolumab), in the chemo group were also assessed. The 3-year OS rates and median OS were: Ope, 66.1% and 31.5 months; Chemo, 39.7% and 18 months, respectively. In the Ope group, addi-tional recurrences were significantly fewer in the patients who underwent adjuvant chemotherapy post-surgery versus the patients who underwent surgery alone (p = 0.013). In the Chemo group, the 3-year OS rate of the patients who received new drugs was significantly better than that of the patients who did not (p = 0.021). Adjuvant chemotherapy after pulmonary metastasectomy may be a preferable treatment option for preventing recurrences. Cetuximab and nivolumab have a potential to improve OS.
尽管肺是头颈部鳞状细胞癌(HNSCC)远处转移最常见的部位,但关于肺转移瘤切除术治疗HNSCC肺转移效果的报道数量有限。1998年至2018年,熊本大学医院在45例HNSCC患者中检测到异时性肺转移。22例患者接受了手术切除(手术组),23例接受了化疗(化疗组)。评估了3年总生存率(OS)和中位OS。还评估了肺转移瘤切除术后辅助化疗以及化疗组中新药(西妥昔单抗和纳武单抗)的效果。3年OS率和中位OS分别为:手术组,66.1%和31.5个月;化疗组,39.7%和18个月。在手术组中,术后接受辅助化疗的患者与仅接受手术的患者相比,额外复发明显更少(p = 0.013)。在化疗组中,接受新药治疗的患者3年OS率明显优于未接受新药治疗的患者(p = 0.021)。肺转移瘤切除术后辅助化疗可能是预防复发的较好治疗选择。西妥昔单抗和纳武单抗有提高总生存率的潜力。