伴有表皮生长因子受体突变和人乳头瘤病毒的鼻腔鼻窦鳞状细胞癌的治疗结果和复发模式。

Treatment outcome and pattern of recurrence of sinonasal squamous cell carcinoma with EGFR-mutation and human papillomavirus.

机构信息

Department of Head and Neck Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi, Japan; Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, 65-banchi, Tsurumai-cho, Showa-ku, Nagoya-shi, Aichi, Nagoya, Japan.

Department of Pathology and Molecular Diagnostics, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi, Nagoya, Japan.

出版信息

J Craniomaxillofac Surg. 2021 Jun;49(6):494-500. doi: 10.1016/j.jcms.2021.02.016. Epub 2021 Feb 22.

DOI:10.1016/j.jcms.2021.02.016

PMID:33676817

Abstract

The objective of our study was to clarify the clinical features of EGFR-mutated sinonasal squamous cell carcinoma (SNSCC) and human papilloma virus (HPV)-related SNSCC. Patients with SNSCC treated from April 2008 to June 2019 at our institution were retrospectively reviewed. We examined EGFR mutation and HPV status for all patients. Main outcomes were overall survival, recurrence, and outcome of each treatment modality. A total of 85 patients with SNSCC were enrolled in this study. EGFR mutations and HPV DNA were detected in 24 (28%) and 7 (8%) patients, respectively. Patients with EGFR-mutated SNSCC showed a worse overall survival (OS) than those with EGFR wild-type in the multivariate analysis (p = 0.037). No death was observed in HPV-positive SNSCC. The cumulative incidence of local recurrence was significantly higher in EGFR mutant than EGFR wild-type tumors (p = 0.03). In patients with EGFR mutations, treatment with induction chemotherapy significantly improved OS (p = 0.01). EGFR-mutated SNSCC have a high-risk feature for recurrence and requires intensive attention for treatment and observation. A new treatment approach, such as EGFR tyrosine kinase inhibitors, may be needed.

摘要

我们的研究目的是阐明表皮生长因子受体（EGFR）突变型鼻窦鳞状细胞癌（SNSCC）和人乳头瘤病毒（HPV）相关 SNSCC 的临床特征。回顾性分析了 2008 年 4 月至 2019 年 6 月在我院接受治疗的 SNSCC 患者。我们对所有患者进行了 EGFR 突变和 HPV 状态检测。主要终点是总生存、复发和每种治疗方式的结局。本研究共纳入 85 例 SNSCC 患者。分别有 24 例（28%）和 7 例（8%）患者检测到 EGFR 突变和 HPV DNA。多因素分析显示，EGFR 突变型 SNSCC 患者的总生存（OS）明显差于 EGFR 野生型患者（p=0.037）。HPV 阳性 SNSCC 患者未观察到死亡。EGFR 突变型肿瘤的局部复发累积发生率明显高于 EGFR 野生型肿瘤（p=0.03）。在 EGFR 突变患者中，诱导化疗显著改善了 OS（p=0.01）。EGFR 突变型 SNSCC 具有高复发风险特征，需要加强治疗和观察。可能需要新的治疗方法，如 EGFR 酪氨酸激酶抑制剂。