鼻窦鳞状细胞癌在诱导化疗与标准治疗后生存结果的比较。
Sinonasal Squamous Cell Carcinoma Survival Outcomes Following Induction Chemotherapy vs Standard of Care Therapy.
机构信息
Department of Otolaryngology-Head and Neck Surgery, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Division of Medical Oncology, Department of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
出版信息
Otolaryngol Head Neck Surg. 2022 Nov;167(5):846-851. doi: 10.1177/01945998221083097. Epub 2022 Mar 8.
OBJECTIVE
To compare oncologic outcomes in sinonasal squamous cell carcinoma (SNSCC) treated with standard of care (SOC) definitive therapy, consisting of surgery or chemoradiotherapy, vs induction therapy followed by definitive therapy.
STUDY DESIGN
Retrospective review.
SETTING
Academic tertiary care hospital.
METHODS
The medical records of patients with biopsy-proven SNSCC treated between 2000 and 2020 were reviewed for demographics, tumor characteristics, staging, treatment details, and oncologic outcomes. Patients were matched 1-to-1 by age, sex, and cancer stage according to treatment received. Time-to-event analyses were conducted.
RESULTS
The analysis included 26 patients with locally advanced SNSCC who received either induction therapy (n = 13) or SOC (n = 13). Baseline demographics, Charlson Comorbidity Index, and median follow-up time were well balanced. Weekly cetuximab, carboplatin, and paclitaxel were the most common induction regimen utilized. Tolerance and safety to induction were excellent. Objective responses were observed in 11 of 13 patients receiving induction. No difference in disease-free survival was found between the induction and SOC groups at 1 or 3 years. However, when compared with SOC, induction therapy resulted in significant improvement in overall survival at 2 years (100% vs 65.3%, = .043) and 3 years (100% vs 48.4%, = .016) following completion of definitive therapy. Two patients in the SOC group developed metastatic disease, as compared with none in the induction group.
CONCLUSIONS
Induction therapy was safe and effective. When compared with SOC, induction therapy improved 3-year overall survival.
目的
比较采用标准治疗（SOC）即手术或放化疗作为根治性治疗的鼻窦鳞状细胞癌（SNSCC）患者与接受诱导治疗后行根治性治疗的患者的肿瘤学结局。
研究设计
回顾性研究。
设置
学术性三级护理医院。
方法
回顾了 2000 年至 2020 年间经活检证实的鼻窦鳞状细胞癌患者的病历资料，以评估其人口统计学、肿瘤特征、分期、治疗细节和肿瘤学结局。根据治疗方法，按年龄、性别和癌症分期进行 1:1 配对。进行生存时间分析。
结果
该分析纳入了 26 例局部晚期鼻窦鳞状细胞癌患者，分别接受诱导治疗（n = 13）或 SOC（n = 13）。基线人口统计学、Charlson 合并症指数和中位随访时间均匹配良好。最常用的诱导方案是每周西妥昔单抗、卡铂和紫杉醇。诱导治疗的耐受性和安全性良好。接受诱导治疗的 13 例患者中有 11 例观察到客观缓解。1 年和 3 年时，诱导组和 SOC 组的无疾病生存率无差异。然而，与 SOC 相比，诱导治疗在完成根治性治疗后 2 年（100%比 65.3%， =.043）和 3 年（100%比 48.4%， =.016）时的总生存率有显著提高。SOC 组有 2 例患者发生转移性疾病，而诱导组无此类患者。
结论
诱导治疗安全有效。与 SOC 相比，诱导治疗可提高 3 年总生存率。
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