Mishra Vachaspati Kumar, Gandhi Ajeet Kumar, Rastogi Madhup, Verma Rakhi, Khurana Rohini, Hadi Rahat, Sharma Vikas, Agarwal Akash, Srivastava Anoop Kumar
Department of Radiation Oncology, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow 226010, Uttar Pradesh, India.
Department of Surgical Oncology, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow 226010, Uttar Pradesh, India.
Ecancermedicalscience. 2023 Nov 16;17:1630. doi: 10.3332/ecancer.2023.1630. eCollection 2023.
The management of inoperable oral cavity squamous cell carcinoma (OC-SCC) is onerous. We aimed to retrospectively analyse the outcome of our cohort of inoperable OC-SCC treated with definitive concurrent chemoradiotherapy (CTRT) with or without induction chemotherapy (IC).
Data of 100 patients (January 2017 to May 2022) of histopathologically proven inoperable OC-SCC treated with definitive CTRT with weekly cisplatin 40 mg/m were retrieved from our departmental archives. Radiotherapy (RT) was delivered with three-dimensional conformal plan (66-70 Gy). Toxicities were evaluated using acute morbidity scoring criteria of Radiation Therapy Oncology Group. The response was evaluated as per WHO criteria. Progression free survival (PFS) was calculated from the date of the start of treatment (IC/CTRT) using Kaplan Meier method.
Median age was 45 years (range 30-80 years). The primary site was oral tongue (59%), retro-molar trigon (15%), buccal mucosa (15%) and others (11%). The stage was III: IVA: IVB in 16:70:14 patients respectively. 72% patients received IC (platinum ± 5 FU ± taxane). Grade 3 skin toxicity, oral mucositis and dysphagia was noted in 13 (13%), 19 (19%) and 13 (13%) patients respectively. The median follow-up duration was 30.5 months (range 6-62 months). Complete response (CR), partial response, progressive disease and death at the time of the last follow-up were 49%, 25%, 15% and 11% respectively. 2-year PFS rate was 49.5%. Stage III patients had a higher CR rate (81.2% versus 42.8%; = 0.0051) and higher 2-year PFS (81.2% versus 46.4%; = 0.0056) in comparison to stage IV patients.
Inoperable patients of OC-SCC treated with definitive CTRT with or without IC yielded CR in approximately half of patients with acceptable toxicity profiles.
不可切除口腔鳞状细胞癌（OC-SCC）的治疗颇具难度。我们旨在回顾性分析接受确定性同步放化疗（CTRT）联合或不联合诱导化疗（IC）的不可切除OC-SCC患者队列的治疗结果。
从我们科室档案中检索出100例（2017年1月至2022年5月）经组织病理学证实为不可切除的OC-SCC患者的数据，这些患者接受了每周40mg/m顺铂的确定性CTRT治疗。放疗（RT）采用三维适形计划（66-70Gy）。使用放射肿瘤学组的急性发病率评分标准评估毒性。根据WHO标准评估反应。采用Kaplan-Meier方法从治疗开始日期（IC/CTRT）计算无进展生存期（PFS）。
中位年龄为45岁（范围30-80岁）。原发部位为舌（59%）、磨牙后三角（15%）、颊黏膜（15%）和其他部位（11%）。分期为III期、IVA期、IVB期的患者分别有16例、70例、14例。72%的患者接受了IC（铂类±5-氟尿嘧啶±紫杉烷）。分别有13例（13%）、19例（19%）和13例（13%）患者出现3级皮肤毒性、口腔黏膜炎和吞咽困难。中位随访时间为30.5个月（范围6-62个月）。在最后一次随访时，完全缓解（CR）、部分缓解、疾病进展和死亡的患者分别占49%、25%、15%和11%。2年PFS率为49.5%。与IV期患者相比，III期患者的CR率更高（81.2%对42.8%；P = 0.0051），2年PFS率也更高（81.2%对46.4%；P = 0.0056）。
接受确定性CTRT联合或不联合IC治疗的不可切除OC-SCC患者中，约一半患者获得了CR，且毒性反应可接受。
