University of Washington, Department of Medicine, Division of Medical Oncology, United States.
Fred Hutchinson Cancer Research Institute, Division of Clinical Biostatistics, United States.
Oral Oncol. 2021 Dec;123:105626. doi: 10.1016/j.oraloncology.2021.105626. Epub 2021 Nov 19.
Timely administration of postoperative radiation therapy (PORT) impacts oncologic outcomes in resected squamous cell carcinomas of the head and neck. Salivary gland cancers (SGCs) are uncommon, and timing of PORT has not been extensively explored. We aimed to determine if the interval between surgery and PORT impacts outcomes in SGCs.
This is a retrospective study of patients with SGCs who underwent curative intent surgical resection followed by adjuvant PORT. Locoregional recurrence free survival (LRFS), disease free survival (DFS), and overall survival (OS) were estimated using the Kaplan Meier method. A multivariate analysis explored the association between demographics, tumor characteristics, and PORT timing with oncologic outcomes using a stepwise Cox proportional hazards model.
180 eligible patients were identified. The median time to PORT start was 61 (range 8-121) days. 169 (93.5%) of patients received neutron radiation. With a median follow up of 8.2 years in surviving patients, the 10-year OS and LRFS estimates were 61% and 53%. In a multivariate analysis, nodal involvement, histologic grade, and age at diagnosis were associated with OS, while nodal involvement, tumor size, and age at diagnosis were associated with LRFS and DFS. Time to PORT start or completion was not statistically associated with survival outcomes.
SGC patients who underwent surgery in our tertiary institution received PORT within a median of 61 days after surgery. With long term follow up, PORT timing in this retrospective series was not associated with worse oncologic outcomes, and support timely administration of PORT.
术后放疗（PORT）的及时给予会影响头颈部鳞状细胞癌切除术后的肿瘤学结果。唾液腺癌（SGCs）并不常见，PORT 的时机尚未广泛探讨。我们旨在确定手术和 PORT 之间的时间间隔是否会影响 SGC 的结果。
这是一项对接受根治性手术切除后接受辅助 PORT 的 SGC 患者的回顾性研究。使用 Kaplan-Meier 方法估计局部区域无复发生存率（LRFS）、无病生存率（DFS）和总生存率（OS）。使用逐步 Cox 比例风险模型的多变量分析探讨了人口统计学、肿瘤特征和 PORT 时间与肿瘤学结果之间的关联。
确定了 180 名合格患者。PORT 开始的中位时间为 61 天（范围 8-121 天）。169 例（93.5%）患者接受了中子放疗。在存活患者的中位随访 8.2 年后，10 年 OS 和 LRFS 估计值分别为 61%和 53%。在多变量分析中，淋巴结受累、组织学分级和诊断时的年龄与 OS 相关，而淋巴结受累、肿瘤大小和诊断时的年龄与 LRFS 和 DFS 相关。PORT 开始或完成的时间与生存结果无统计学关联。
在我们的三级机构接受手术的 SGC 患者在手术后中位数 61 天内接受 PORT。在长期随访中，本回顾性系列中 PORT 时间与肿瘤学结果没有相关性，支持及时给予 PORT。
