Qiu Wenlong, Yang Yong, Sun Shiran, Zhou Fengge, Xu Yi, Luo Xi, Wang Zekun, He Meilin, Liu Yang, Yi Junlin
Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Front Oncol. 2021 Feb 15;10:618564. doi: 10.3389/fonc.2020.618564. eCollection 2020.
Primary squamous cell carcinoma of parotid gland (parotid SCC) is a high malignant histologic subtype of parotid cancers with aggressive clinical presentation. However, the clinical features and survival benefit of postoperative radiotherapy (PORT) for primary parotid SCC are not well known.
A retrospective population-based study was performed to identify the role of PORT in parotid SCC patients diagnosed between 1975 and 2016 from SEER database. A prognostic risk model was established based on patient clinical features, including age, tumor stage, and node involvement status. Patients were stratified into high, intermediate, and low risk according to this model. The survival benefit of radiotherapy was compared in the whole cohort and different risk groups.
Nine hundred thirty-one parotid SCC patients were extracted from SEER database, 634 (68.1%) in the RT group and 286 (30.7%) in the non-RT group. Overall, 503 (54.0%) deaths occurred, with a median follow-up of 84 months, the 5-year OS was 43.6% in the whole cohort, 47.7 35.9% in patients with/without PORT (P = 0.005), and 58.9 38.8 27.1% in low-, intermediate-, and high-risk group (P < 0.001). Compared with surgery alone, PORT significantly improved the OS of patients with medium risk (47.5 20.6, P < 0.001), whereas not in the low risk (61 54%, P = 0.710) and high (25.6 28.7%, P = 0.524).
This prognostic model can separate the patients with parotid squamous cell carcinoma into different risk. PORT significantly improved the OS of patients with intermediate risk, whereas high-risk group may need more intensive treatment strategies.
腮腺原发性鳞状细胞癌（腮腺鳞癌）是腮腺癌中具有侵袭性临床表现的高恶性组织学亚型。然而，原发性腮腺鳞癌术后放疗（PORT）的临床特征和生存获益尚不清楚。
进行一项基于人群的回顾性研究，以确定PORT在1975年至2016年间从监测、流行病学和最终结果（SEER）数据库诊断的腮腺鳞癌患者中的作用。基于患者的临床特征，包括年龄、肿瘤分期和淋巴结受累情况，建立了一个预后风险模型。根据该模型，将患者分为高、中、低风险组。比较了整个队列和不同风险组放疗的生存获益。
从SEER数据库中提取了931例腮腺鳞癌患者，放疗组634例（68.1%），非放疗组286例（30.7%）。总体而言，发生503例（54.0%）死亡，中位随访84个月，整个队列的5年总生存率为43.6%，接受/未接受PORT的患者分别为47.7%和35.9%（P = 0.005），低、中、高风险组分别为58.9%、38.8%和27.1%（P < 0.001）。与单纯手术相比，PORT显著改善了中度风险患者的总生存率（47.5%对20.6%，P < 0.001），而低风险（61%对54%，P = 0.710）和高风险（25.6%对28.7%，P = 0.524）患者则未改善。
该预后模型可将腮腺鳞状细胞癌患者分为不同风险组。PORT显著改善了中度风险患者的总生存率，而高风险组可能需要更强化的治疗策略。
