Tan Mingyu, Chen Yanliang, Du Tianqi, Wang Qian, Wu Xun, Wang Xiaohu, Luo Hongtao, Sun Shilong, Zhang Qiuning, Yuan Wenzhen
The First School of Clinical Medicine, Lanzhou University, Lanzhou, China.
Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou, China.
Transl Cancer Res. 2024 Nov 30;13(11):6045-6056. doi: 10.21037/tcr-24-1221. Epub 2024 Nov 27.
Treating patients with head and neck adenoid cystic carcinoma (HNACC) presents surgical problems in various scenarios. Limited studies explore definitive radiation's impact on patient survival, with inadequate data correlating it to postoperative radiotherapy. Using the Surveillance, Epidemiology, and End Results (SEER) program, we conducted an objective analysis to evaluate the impact of definitive radiation on the survival of HNACC patients without distant metastases, aiming to uncover its nuanced pros and cons.
This study conducted a comprehensive analysis of individuals diagnosed with HNACC within the SEER database from 2000 to 2023. Disease-specific survival (DSS) and overall survival (OS) were evaluated using diverse statistical methods. Propensity score matching (PSM) reduced covariate variations and selection biases, allowing for comparisons of postoperative and definitive radiotherapy groups.
A total of 2,072 patients were encompassed within this study. The postoperative radiotherapy group yielded significant advantages in OS and DSS (P<0.001). In matched cohorts, the 5-year prognostic OS stood at 55% and 37%, respectively, while DSS figures were 65% and 46%, correspondingly. In advanced T4 cases, DSS differences lacked significance (P=0.42). Additionally, the outcomes of OS and DSS were notably influenced by variables such as T-stage, N-stage, tumor stage, and chemotherapy.
Surgical intervention remains a pivotal component of comprehensive treatment for patients diagnosed with operable HNACC. Definitive radiation is appropriate for less treatable situations, particularly in local advanced HNACC. Systemic treatment may assist HNACC patients at risk of distant metastases.
治疗头颈部腺样囊性癌（HNACC）患者在各种情况下都存在手术问题。有限的研究探讨了根治性放疗对患者生存的影响，且将其与术后放疗相关的数据不足。我们利用监测、流行病学和最终结果（SEER）计划进行了客观分析，以评估根治性放疗对无远处转移的HNACC患者生存的影响，旨在揭示其细微的利弊。
本研究对2000年至2023年SEER数据库中诊断为HNACC的个体进行了全面分析。使用多种统计方法评估疾病特异性生存（DSS）和总生存（OS）。倾向评分匹配（PSM）减少了协变量差异和选择偏倚，从而能够比较术后放疗组和根治性放疗组。
本研究共纳入2072例患者。术后放疗组在OS和DSS方面具有显著优势（P<0.001）。在匹配队列中，5年预测OS分别为55%和37%，而DSS数据分别为65%和46%。在晚期T4病例中，DSS差异无统计学意义（P=0.42）。此外，OS和DSS的结果受到T分期、N分期、肿瘤分期和化疗等变量的显著影响。
手术干预仍然是诊断为可手术的HNACC患者综合治疗的关键组成部分。根治性放疗适用于较难治疗的情况，特别是局部晚期HNACC。全身治疗可能有助于有远处转移风险的HNACC患者。
