Chen R H, Liang F Y, Han P, Lin P L, Lin X J, Wang J Y, Kong X W, Huang X M
Department of Otolaryngology, Head and Neck Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University,Guangzhou 510280, China Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangzhou 510280, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2024 Apr 7;59(4):329-334. doi: 10.3760/cma.j.cn115330-20231205-00273.
To evaluate the efficacy of neoadjuvant chemoimmunotherapy (NACI) combined with transoral robotic surgery (TORS) in the treatment of locally advanced oropharyngeal squamous cell carcinoma (OPSCC). This was a retrospective study of 15 patients with locally advanced OPSCC who underwent TORS after neoadjuvant therapy (NAT) at the Department of Otolaryngology-Head and Neck Surgery of Sun Yat-sen Memorial Hospital of Sun Yat-sen University from April 2019 to February 2023. There were 12 males and 3 females, aged 31 to 74 years. Twelve cases were tonsil cancer, and 3 cases were tongue base cancer. There were 11 cases in stage Ⅲ and 4 cases in stage Ⅳ. Two patients received neoadjuvant chemotherapy and 13 patients received NACI, with 2 to 3 cycles, and all patients underwent TORS after multidisciplinary team consultation. The clinicopathological characteristics, surgical outcomes, and oncological results were summarized. All surgeries were successfully completed with negative surgical margins, and no case was required conversion surgery. All patients were fed via nasogastric tubes postoperatively, with a median gastric tube stay of 7 days (range: 2-60 days). No tracheotomy was applied. There were no major complications such as postoperative bleeding. Pathological complete response (pCR) was found in 10 cases (76.9%) among the 13 patients with NACI. The follow-up time was 21 months (range: 10-47 months), and there was no death or distant metastasis. One patient with rT0N3M0 tonsil cancer had local recurrence 5 months after surgery. The 2-year overall survival and 2-year disease-free survival were respectively 100.0% and 93.3% in the 15 patients. NACI combined with TORS provides a safe, effective and minimally invasive treatment for patients with locally advanced oropharyngeal squamous cell carcinoma.
评估新辅助化疗免疫疗法（NACI）联合经口机器人手术（TORS）治疗局部晚期口咽鳞状细胞癌（OPSCC）的疗效。这是一项回顾性研究，对2019年4月至2023年2月在中山大学孙逸仙纪念医院耳鼻咽喉头颈外科接受新辅助治疗（NAT）后行TORS的15例局部晚期OPSCC患者进行研究。其中男性12例，女性3例，年龄31至74岁。12例为扁桃体癌，3例为舌根癌。Ⅲ期11例，Ⅳ期4例。2例患者接受新辅助化疗，13例患者接受NACI，2至3个周期，所有患者经多学科团队会诊后行TORS。总结临床病理特征、手术结果和肿瘤学结果。所有手术均成功完成，手术切缘阴性，无一例需要改行手术。所有患者术后均经鼻胃管进食，胃管留置时间中位数为7天（范围：2至60天）。未行气管切开术。无术后出血等严重并发症。13例接受NACI的患者中，10例（76.9%）出现病理完全缓解（pCR）。随访时间为21个月（范围：10至47个月），无死亡或远处转移。1例rT0N3M0扁桃体癌患者术后5个月出现局部复发。15例患者的2年总生存率和2年无病生存率分别为100.0%和93.3%。NACI联合TORS为局部晚期口咽鳞状细胞癌患者提供了一种安全、有效且微创的治疗方法。
