术后放疗对于局部晚期头颈部鳞状细胞癌可能并非必要：一项病例匹配的多中心研究。
Postoperative radiotherapy may not be necessary for locally advanced head and neck squamous cell carcinoma: a case-match multicentre study.
机构信息
Department of Oral and Maxillofacial Surgery, Second Xiangya Hospital of Central South University, Changsha, Hunan, China.
Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai, China.
出版信息
BMC Oral Health. 2022 Jun 24;22(1):253. doi: 10.1186/s12903-022-02288-x.
BACKGROUND
Some head and neck cancer surgeons found that many patients with locally advanced head and neck squamous cell carcinoma (LA-HNSCC) without postoperative radiotherapy (PORT) also have a good prognosis. The purpose of this study was to determine the effect of PORT on survival in patients with LA-HNSCC.
METHODS
A case-match cohort analysis was performed at two institutions on patients with LA-HNSCC. Patients who received surgery alone were case-matched 1: 1 with patients treated by surgery plus PORT based on pT, pN, tumor subsite etc. RESULTS: 114 patients were matched into 57 pairs, with a median follow-up period of 40.2 months. No difference in overall survival (OS, HR 0.88; 95% CI 0.50-1.58; P = 0.79) or disease-specific survival (DFS, 0.86; 95% CI 0.50-1.50; P = 0.76) was observed with no PORT.
CONCLUSIONS
PORT isn't necessary for patients with LA-HNSCC who are treated for the first time as long as the head and neck cancer surgeon adhere to appropriate surgical concepts. The indications of PORT for patients with LA-HNSCC need to be further discussed.
背景
一些头颈部癌症外科医生发现，许多局部晚期头颈部鳞状细胞癌（LA-HNSCC）患者在没有术后放疗（PORT）的情况下也有良好的预后。本研究的目的是确定 PORT 对 LA-HNSCC 患者生存的影响。
方法
在两个机构对 LA-HNSCC 患者进行了病例匹配队列分析。接受单纯手术治疗的患者根据 pT、pN、肿瘤部位等与接受手术加 PORT 治疗的患者进行 1:1 病例匹配。
结果
114 例患者匹配为 57 对，中位随访时间为 40.2 个月。无 PORT 组患者的总生存率（OS，HR 0.88；95%CI 0.50-1.58；P=0.79）或疾病特异性生存率（DFS，0.86；95%CI 0.50-1.50；P=0.76）无差异。
结论
只要头颈癌外科医生坚持适当的手术理念，首次治疗的 LA-HNSCC 患者不需要 PORT。LA-HNSCC 患者 PORT 的适应证需要进一步讨论。
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