Wang Mengwen, Zhao Baitian, Huang Amin, Song Ming, Wang Jia, Liu Panpan
State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, China.
Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou 510060, China.
J Cancer. 2025 Jan 1;16(3):996-1007. doi: 10.7150/jca.105254. eCollection 2025.
The role of radiation therapy in patients with distant metastatic squamous cell carcinoma of the head and neck (mHNSCC) is unclear. In this study, we compare the differences in survival among mHNSCC patients treated with chemotherapy plus radiotherapy (RT) vs. chemotherapy alone.
This study included patients with distant mHNSCC recruited from 2 cohorts: The Surveillance, Epidemiology, and End Results (SEER [=885]) database and a Chinese single-institution registry in Sun Yat-sen University Cancer Center (SYSUCC [=60]). The SEER cohort included 600 patients received RT plus chemotherapy and 285 patients received chemotherapy alone; in the SYSUCC cohort, 40 patients received RT plus chemotherapy and 20 patients received chemotherapy alone were recruited. The period of data collection for the SEER study was from January 2010 to December 2015, and that for SYSUCC was from January 2010 to December 2020. The study's primary outcome was overall survival (OS), with disease-specific survival (DSS) as a secondary outcome.
Of the 885 patients in the SEER cohort, the addition of RT to chemotherapy increased one-year OS from 46.6% to 56.0% compared with chemotherapy alone ( =0.009) and from 10.4% to 25.1% for three-year OS ( <0.001). Patients who received RT in addition to chemotherapy were also more likely to have better three-year DSS than those who received chemotherapy alone (28.9% vs. 14.0%, <0.001). Similarly, in the SYSUCC cohort, patients who received chemotherapy plus RT had better three-year OS than chemotherapy alone (62.8% vs. 21.0%, =0.003). The addition of RT to chemotherapy increased median OS among patients with mHNSCC from 10 months to 13 months in the SEER cohort and from 14 months to 29 months in the SYSUCC cohort.
Radiotherapy in addition to chemotherapy significantly improved OS and DSS in patients with mHNSCC.
放射治疗在远处转移的头颈部鳞状细胞癌（mHNSCC）患者中的作用尚不清楚。在本研究中，我们比较了接受化疗加放疗（RT）与单纯化疗的mHNSCC患者的生存差异。
本研究纳入了从2个队列中招募的远处转移mHNSCC患者：监测、流行病学和最终结果（SEER [=885]）数据库以及中山大学肿瘤防治中心的一个中国单机构登记处（SYSUCC [=60]）。SEER队列包括600例接受放疗加化疗的患者和285例单纯接受化疗的患者；在SYSUCC队列中，招募了40例接受放疗加化疗的患者和20例单纯接受化疗的患者。SEER研究的数据收集期为2010年1月至2015年12月，SYSUCC的数据收集期为2010年1月至2020年12月。该研究的主要结局是总生存期（OS），疾病特异性生存期（DSS）作为次要结局。
在SEER队列的885例患者中，与单纯化疗相比，化疗联合放疗使一年OS率从46.6%提高到56.0%（P =0.009），三年OS率从10.4%提高到25.1%（P<0.001）。与单纯接受化疗的患者相比，接受化疗加放疗的患者三年DSS也更有可能更好（28.9%对14.0%，P<0.001）。同样，在SYSUCC队列中，接受化疗加放疗的患者三年OS优于单纯化疗（62.8%对21.0%，P =0.003）。在SEER队列中，化疗联合放疗使mHNSCC患者的中位OS从10个月增加到13个月，在SYSUCC队列中从14个月增加到29个月。
化疗联合放疗显著改善了mHNSCC患者的OS和DSS。
