Berzenji Diako, Monserez Dominiek A, Verduijn Gerda M, Dronkers Emilie A C, Jansen Peter P, Keereweer Stijn, Sewnaik Aniel, Baatenburg de Jong Robert J, Hardillo Jose A
Department of Otorhinolaryngology and Head and Neck Surgery Erasmus University Medical Center Rotterdam The Netherlands.
Department of Radiation Oncology Erasmus University Medical Center Rotterdam The Netherlands.
Laryngoscope Investig Otolaryngol. 2021 Mar 26;6(2):211-218. doi: 10.1002/lio2.539. eCollection 2021 Apr.
To compare the impact on survival and late radiation toxicity of patients with squamous cell carcinoma of unknown primary who were treated with ipsilateral neck dissection and ipsilateral postoperative radiotherapy (PORT) and patients treated with ipsilateral neck dissection and PORT to both sides of the neck plus the pharyngeal axis.
Retrospective cohort study performed at the Erasmus University Medical Center in which 78 patients with squamous cell carcinoma of unknown primary were identified. Thirty-nine patients received PORT to both sides of the neck plus the pharyngeal axis (BILAX) and another 39 patients were irradiated on the ipsilateral neck (IPSI) only. The endpoints of the present study were 3-year overall survival (OS), 3-year disease-free survival (DFS), and overall late radiation toxicity.
The 3-year OS rate of the entire group of 78 patients was 74.2% and the 3-year DFS rate was 72.7%. The 3-year OS rates for the IPSI and the BILAX groups were 74.4% and 74.1%, respectively ( = .654). The most common late radiation toxicity experienced was xerostomia (64.8%), which was significantly more often seen in the BILAX group than in the IPSI group (83.8% and 44.1%, respectively, = .001). Overall late radiation toxicity was significantly higher in the BILAX group ( = .003).
There was no significant difference in OS and DFS rates between the IPSI and the BILAX group. Late radiation toxicity was significantly higher in the BILAX group.
Level 2b: Individual retrospective cohort study.
比较接受同侧颈部清扫术及同侧术后放疗（PORT）的原发灶不明的鳞状细胞癌患者与接受同侧颈部清扫术及双侧颈部加咽轴PORT的患者的生存情况及晚期放射毒性。
在伊拉斯姆斯大学医学中心进行的一项回顾性队列研究，共纳入78例原发灶不明的鳞状细胞癌患者。39例患者接受双侧颈部加咽轴PORT（BILAX），另外39例患者仅接受同侧颈部放疗（IPSI）。本研究的终点为3年总生存率（OS）、3年无病生存率（DFS）及总体晚期放射毒性。
78例患者的3年OS率为74.2%，3年DFS率为72.7%。IPSI组和BILAX组的3年OS率分别为74.4%和74.1%（P = 0.654）。最常见的晚期放射毒性是口干（64.8%），BILAX组的口干发生率显著高于IPSI组（分别为83.8%和44.1%，P = 0.001）。BILAX组的总体晚期放射毒性显著更高（P = 0.003）。
IPSI组和BILAX组的OS率和DFS率无显著差异。BILAX组的晚期放射毒性显著更高。
2b级：个体回顾性队列研究。
