口腔鳞状细胞癌一期手术及同侧颈部清扫术后颈部放疗体积对长期非刺激性唾液流量的影响
Impact of Postoperative Neck Radiotherapy Volumes on Long-Term Unstimulated Saliva Flow Following Primary Surgery and Ipsilateral Neck Dissection for Oral Cavity Squamous Cell Carcinoma.
作者信息
Rooney Claire M, Huang Shao Hui, Su Jie, Bratman Scott, Cho John, de Almeida John, Glogauer Michael, Goldstein David, Hahn Ezra, Hosni Ali, Hope Andrew, Irish Jonathan, Kim John, O'Sullivan Brian, Ringash Jolie, Spreafico Anna, Tsai Jillian, Waldron John, Yao Christopher, Watson Erin, McPartlin Andrew
机构信息
Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Canada.
Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, Canada.
出版信息
Head Neck. 2025 Mar;47(3):847-855. doi: 10.1002/hed.27988. Epub 2024 Oct 30.
BACKGROUND
We investigate the association of postoperative radiotherapy (PORT) volumes and salivary function in oral cavity SCC (OSCC).
METHODS
OSCC patients undergoing PORT 2005-2021 underwent modified Schirmer test (MST) pre-PORT, 6 and/or 12 months post-PORT. Hyposalivation rates were compared by PORT volumes. MVA identified predictors for chronic hyposalivation.
RESULTS
Among 165 eligible patients, 88 (53%) received bilateral, 66 (40%) ipsilateral, and 11 (7%) no-neck (primary-only) PORT. Baseline characteristics were similar, except more N2b/N2c disease received bilateral PORT vs. ipsilateral or no-neck (60% vs. 36% vs. 0%, p < 0.001). Baseline hyposalivation was similar (26% vs. 30% vs. 18%, p = 0.67). Hyposalivation occurred more frequently in bilateral vs. ipsilateral vs. no-neck PORT at 6 (90% vs. 62% vs. 9%) and 12 months (90% vs. 48% vs. 0%) (both p < 0.001). On MVA, bilateral neck PORT and smoking predicted chronic hyposalivation.
CONCLUSION
Increasing PORT volumes predict saliva function recovery and chronic hyposalivation, informing treatment discussions.
背景
我们研究口腔鳞状细胞癌（OSCC）术后放疗（PORT）体积与唾液功能之间的关联。
方法
2005年至2021年接受PORT的OSCC患者在PORT前、PORT后6个月和/或12个月接受改良的Schirmer试验（MST）。通过PORT体积比较唾液分泌减少率。多变量分析（MVA）确定慢性唾液分泌减少的预测因素。
结果
在165例符合条件的患者中，88例（53%）接受双侧PORT，66例（40%）接受同侧PORT，11例（7%）接受无颈部（仅原发灶）PORT。除了更多N2b/N2c期疾病患者接受双侧PORT而非同侧或无颈部PORT外（60%对36%对0%，p<0.001），基线特征相似。基线时唾液分泌减少情况相似（26%对30%对18%，p=0.67）。在6个月（90%对62%对9%）和12个月（90%对48%对0%）时，双侧PORT组比同侧PORT组和无颈部PORT组唾液分泌减少更频繁（均p<0.001）。在多变量分析中，双侧颈部PORT和吸烟是慢性唾液分泌减少的预测因素。
结论
PORT体积增加预示唾液功能恢复及慢性唾液分泌减少，为治疗讨论提供依据。
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