Gupta Gauri, Sharma Ashish, Bhutani Himanshu
Oral and Maxillofacial Surgery, ITS Dental College, Hospital and Research Centre, Greater Noida, IND.
Cureus. 2024 Dec 20;16(12):e76071. doi: 10.7759/cureus.76071. eCollection 2024 Dec.
Introduction The role of concomitant chemoradiation therapy (CTRT) or radiation therapy (RT) is not well defined in operated cases of oral squamous cell carcinoma (OSCC) with positive perineural spread. The purpose of the study was to determine whether the use of concurrent CTRT or RT would enhance the five-year disease-free survival of patients with positive perineural invasion (PNI). Materials and methods Data were analysed retrospectively from January 2014 to December 2023. Patients were placed into three groups: surgery only, surgery with RT, and surgery with concomitant CTRT. In all, 180 cases of pT1-3N0 and pT1-3N+ OSCC patients had tumour-free margins, of which 24 cases (13.4%) had perineural invasion. Based on treatment modalities, 45.8% of the cases underwent surgery with CTRT (group III), 33.3% opted for surgery with RT (group II), and 20.9% underwent surgery only (group I). Five-year recurrence-free survival was analysed among the three groups using the Kaplan-Meier model. Results There was no significant difference among the three groups in terms of recurrence (p = 0.817) or five-year survival rate (p = 0.0935). Conclusion Altogether, the data seem to indicate that radical surgical resection alone should be considered sufficient treatment for OSCC patients with pT1-3N0 disease, even in the presence of perineural invasion. Thus, it can be concluded that the addition of concomitant CTRT or RT does not significantly increase the five-year disease-free survival of patients with OSCC with positive PNI.
引言 在手术切除的伴有神经周围扩散阳性的口腔鳞状细胞癌（OSCC）病例中，同步放化疗（CTRT）或放疗（RT）的作用尚未明确界定。本研究的目的是确定同步CTRT或RT的使用是否会提高伴有神经周围侵犯（PNI）阳性患者的五年无病生存率。
材料与方法 回顾性分析2014年1月至2023年12月的数据。患者分为三组：单纯手术组、手术联合RT组和手术联合同步CTRT组。总共180例pT1 - 3N0和pT1 - 3N + 的OSCC患者切缘无肿瘤，其中24例（13.4%）有神经周围侵犯。根据治疗方式，45.8%的病例接受了同步CTRT手术（III组），33.3%选择了手术联合RT（II组），20.9%仅接受了手术（I组）。使用Kaplan - Meier模型分析三组患者的五年无复发生存率。
结果 三组在复发（p = 0.817）或五年生存率（p = 0.0935）方面无显著差异。
结论 总体而言，数据似乎表明，对于pT1 - 3N0疾病的OSCC患者，即使存在神经周围侵犯，单纯根治性手术切除也应被视为足够的治疗方法。因此，可以得出结论：对于PNI阳性的OSCC患者，添加同步CTRT或RT并不会显著提高其五年无病生存率。
