Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany.
Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg University Hospital, Heidelberg, Germany.
Technol Cancer Res Treat. 2024 Jan-Dec;23:15330338241258596. doi: 10.1177/15330338241258596.
Postoperative radiotherapy can improve locoregional control (LC) in oral cavity squamous cell carcinoma (OCSCC) patients with positive resection margins. The present study aimed to evaluate the impact of surgical margin size on LC in this patient population.
This retrospective study involved 162 patients with OCSCC who underwent postoperative radiotherapy between 2000 and 2020 at the Department of Radiation Oncology, University Hospital Heidelberg and the German Cancer Research Center. The study aimed to determine the impact of different resection margins on LC, as well as overall survival (OS), progression-free survival (PFS), and treatment-related toxicity (CTCAE 4.03).
Seventy-seven patients (47.5%) had involved (<1 mm) margins, 22 patients (13.6%) close (≤5 mm) margins, and 63 patients (38.9%) clear (>5 mm) margins. A surgical margin ≤ 5 mm was a significant predictor for worse LC (HR 2.6, 95% CI 1.2, 6.1), but not for OS (HR 1.2, CI 0.7, 1.9) or PFS (HR 1.2, 0.7, 2.0).
Patients who have narrow resection margins (1-5 mm) experience poor local control and should receive postoperative radiotherapy. It is necessary to conduct further prospective studies to determine whether a narrower margin window could be achieved to better determine the appropriate indication for adjuvant radiotherapy.
术后放疗可以提高切缘阳性的口腔鳞状细胞癌（OCSCC）患者的局部区域控制（LC）。本研究旨在评估手术切缘大小对该患者人群 LC 的影响。
本回顾性研究纳入了 2000 年至 2020 年期间在海德堡大学医院和德国癌症研究中心放射肿瘤学系接受术后放疗的 162 例 OCSCC 患者。该研究旨在确定不同切缘对 LC、总生存率（OS）、无进展生存率（PFS）和治疗相关毒性（CTCAE 4.03）的影响。
77 例患者（47.5%）切缘阳性（<1 mm），22 例患者（13.6%）切缘紧邻（≤5 mm），63 例患者（38.9%）切缘阴性（>5 mm）。手术切缘≤5 mm 是 LC 较差的显著预测因素（HR 2.6，95%CI 1.2，6.1），但不是 OS（HR 1.2，CI 0.7，1.9）或 PFS（HR 1.2，0.7，2.0）。
切缘较窄（1-5 mm）的患者局部控制效果较差，应接受术后放疗。有必要开展进一步的前瞻性研究，以确定能否实现更窄的切缘范围，从而更好地确定辅助放疗的适当适应证。
