Wu Qiuji, Wang Juan, Li Shaojie, Liu Jia, Cheng Yanshuang, Jin Jieying, Zhong Yahua
Department of Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University, Wuhan 430071, China.
Hubei Key Laboratory of Tumor Biological Behaviors, Zhongnan Hospital of Wuhan University, Wuhan 430071, China.
J Clin Med. 2023 Apr 24;12(9):3099. doi: 10.3390/jcm12093099.
Head and neck soft-tissue sarcomas are rare but aggressive malignancies. Definitive radiotherapy might be an alternative treatment choice in patients unfit for surgery with preservation of organ function and facial morphology. Whether definitive radiotherapy is comparable with surgery has not been fully demonstrated. In this study, we compared the prognosis of patients with radiotherapy-based treatment and with surgery-based treatment. From May 2014 to February 2021, patients with locally advanced head and neck soft-tissue sarcoma treated with either definitive radiotherapy-based treatment or radical surgery-based treatment were retrospectively enrolled. Clinical outcomes including tumor response, patients' survival and acute treatment-related toxicities were evaluated. Kaplan-Meier curves with log-rank test were used to compare survival data. Cox regression analysis was used to explore prognostic factors. A total of 24 patients (12 males and 12 females, 3 to 61 years old) were eligible for analysis. The median follow-up time was 49 (range: 6-96) months. In 16 patients receiving definitive radiotherapy-based treatment, 6 reached complete response. The survival curve showed that there was no statistically significant difference in overall survival (OS), distant metastasis-free survival (DMFS), loco-regional relapse-free survival (LRRFS) and progression-free survival (PFS) between the two groups of patients ( 0.35, 0.24, 0.48, 0.1, respectively). COX regression analysis showed that older age was associated with poor DMFS. There was no significant difference in grade 3-4 toxicities between the two groups. In cases of contradictions to surgery, refusal to surgery or failure to complete resection, chemoradiotherapy might be an alternative treatment option.
头颈部软组织肉瘤罕见但具有侵袭性。对于不适合手术的患者，确定性放疗可能是一种可保留器官功能和面部形态的替代治疗选择。确定性放疗是否与手术相当尚未得到充分证实。在本研究中，我们比较了接受放疗为主治疗和手术为主治疗患者的预后。2014年5月至2021年2月，对接受确定性放疗为主治疗或根治性手术为主治疗的局部晚期头颈部软组织肉瘤患者进行回顾性纳入。评估包括肿瘤反应、患者生存和急性治疗相关毒性在内的临床结局。采用Kaplan-Meier曲线和对数秩检验比较生存数据。采用Cox回归分析探索预后因素。共有24例患者（男12例，女12例，年龄3至61岁）符合分析条件。中位随访时间为49（范围：6 - 96）个月。在16例接受确定性放疗为主治疗的患者中，6例达到完全缓解。生存曲线显示，两组患者的总生存期（OS）、无远处转移生存期（DMFS）、无局部区域复发生存期（LRRFS）和无进展生存期（PFS）之间无统计学显著差异（分别为0.35、0.24、0.48、0.1）。COX回归分析显示，年龄较大与较差的DMFS相关。两组之间3 - 4级毒性无显著差异。在存在手术矛盾、拒绝手术或未能完成切除的情况下，放化疗可能是一种替代治疗选择。
