Department of Head and Neck Surgery, Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, 651 Dong Feng Road East, Guangzhou, 510060, China.
Department of Clinical Research, Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, 510060, China.
Sci Rep. 2022 Aug 11;12(1):13696. doi: 10.1038/s41598-022-17932-3.
The significance of postoperative radiotherapy (PORT) to the neck for pN1 status head and neck squamous cell carcinomas (HNSCC) after neck dissection is unclear. A total of 208 patients with pN1 status HNSCC treated from January 1, 2001, to December 31, 2014, were enrolled in the current study. The 5-year regional recurrence-free survival (RRFS), overall survival (OS) and distant metastasis-free survival (DMFS) were compared between patients with or without PORT to the dissected neck. Moreover, the stratified Cox proportional hazards models were used to assess the association between PORT to the neck and survival before and after propensity score matching. Seventy-nine patients received PORT to the neck, while 129 did not. All patients were followed for over 5 years, with a median follow-up duration of 64.6 months. The PORT group did not show better survival results than the group without PORT to the neck in RRFS, OS or DMFS. Moreover, no evidence showed that PORT to the neck was independently associated with 5-year survival. PORT to the neck for pN1 status HNSCC after neck dissection did not lead to better survival. However, it is necessary to conduct prospective randomized clinical trials to confirm these results.
术后放疗（PORT）对颈清扫术后 pN1 期头颈部鳞状细胞癌（HNSCC）颈部的意义尚不清楚。本研究共纳入 208 例 2001 年 1 月 1 日至 2014 年 12 月 31 日接受治疗的 pN1 期 HNSCC 患者。比较了颈部清扫术后 PORT 与无 PORT 患者的 5 年区域无复发生存率（RRFS）、总生存率（OS）和无远处转移生存率（DMFS）。此外，还使用分层 Cox 比例风险模型评估了 PORT 与倾向性评分匹配前后生存的相关性。79 例患者接受了 PORT，129 例患者未接受。所有患者的随访时间均超过 5 年，中位随访时间为 64.6 个月。PORT 组在 RRFS、OS 或 DMFS 方面的生存结果并不优于无 PORT 组。此外，没有证据表明 PORT 与 5 年生存率独立相关。颈清扫术后 pN1 期 HNSCC 行 PORT 并未带来更好的生存。然而，有必要开展前瞻性随机临床试验来证实这些结果。
