Wang Jingbo, Moon Ji Eun, Guo Xin, Yu Jiaqi, Yi Junlin, Bae Sun Hyun
Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Panjiayuannanli, Chaoyang District, Beijing 100021, China.
Department of Biostatistics, Soonchunhyang University College of Medicine, Bucheon, 170 Jomaru-ro, Wongmi-gu, Bucheon-si 14584, Gyeonggi-do, Republic of Korea.
Cancers (Basel). 2024 Jun 28;16(13):2375. doi: 10.3390/cancers16132375.
Because of the rarity, heterogeneous histology, and diverse anatomical sites of salivary gland cancer (SGC), there are a limited number of clinical studies on its management. This study reports the cumulative evidence of postoperative radiotherapy (PORT) for SGC of the head and neck.
A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched the PubMed, Embase, Cochrane Library, and Web of Science databases between 7th and 10th November 2023.
A total of 2962 patients from 26 studies between 2007 and 2023 were included in this meta-analysis. The median RT dose was 64 Gy (range: 56-66 Gy). The median proportions of high-grade, pathological tumor stage 3 or 4 and pathological lymph node involvement were 42% (0-100%), 40% (0-77%), and 31% (0-75%). The pooled locoregional control rates at 3, 5, and 10 years were 92% (95% confidence interval [CI], 89-94%), 89% (95% CI, 86-93%), and 84% (95% CI, 73-92%), respectively. The pooled disease-free survival (DFS) rates at 3, 5, and 10 years were 77% (95% CI, 70-83%), 67% (95% CI, 60-74%), and 61% (95% CI, 55-67%), respectively. The pooled overall survival rates at 3, 5, and 10 years were 84% (95% CI, 79-88%), 75% (95% CI, 72-79%), and 68% (95% CI, 62-74%), respectively. Severe late toxicity ≥ grade 3 occurred in 7% (95% CI, 3-14%).
PORT showed favorable long-term efficacy and safety in SGC, especially for patients with high-grade histology. Considering that DFS continued to decrease, further clinical trials exploring treatment intensification are warranted.
由于唾液腺癌（SGC）罕见、组织学异质性以及解剖部位多样，关于其治疗的临床研究数量有限。本研究报告了头颈部SGC术后放疗（PORT）的累积证据。
根据系统评价和Meta分析的首选报告项目指南进行系统评价。我们于2023年11月7日至10日检索了PubMed、Embase、Cochrane图书馆和科学网数据库。
本Meta分析纳入了2007年至2023年间26项研究中的2962例患者。放疗中位剂量为64 Gy（范围：56 - 66 Gy）。高级别、病理肿瘤分期为3期或4期以及病理淋巴结受累的中位比例分别为42%（0 - 100%）、40%（0 - 77%）和31%（0 - 75%）。3年、5年和10年的局部区域控制率分别为92%（95%置信区间[CI]，89 - 94%）、89%（95% CI，86 - 93%）和84%（95% CI，73 - 92%）。3年、5年和10年的无病生存率分别为77%（95% CI，70 - 83%）、67%（95% CI，60 - 74%）和61%（95% CI，55 - 67%）。3年、5年和10年的总生存率分别为84%（95% CI，79 - 88%）、75%（95% CI，72 - 79%）和68%（95% CI，62 - 74%）。≥3级的严重晚期毒性发生率为7%（95% CI，3 - 14%）。
PORT在SGC中显示出良好的长期疗效和安全性，尤其是对于高级别组织学类型的患者。考虑到无病生存率持续下降，有必要进一步开展探索强化治疗的临床试验。
