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辅助放疗在具有轻微不良特征的早期口腔癌中的作用:单机构经验

The Role of Adjuvant Radiotherapy for Early-Stage Oral Cavity Cancer With Minor Adverse Features; A Single Institute Experience.

作者信息

Yosefof Eyal, Edri Nofar, Kurman Noga, Bachar Gideon, Shpitzer Thomas, Mizrachi Aviram, Popovtzer Aron

机构信息

Department of Otolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel.

Institute of Oncology, Davidoff Center, Rabin Medical Center, Petach Tikva, Israel.

出版信息

Head Neck. 2025 Jul;47(7):1839-1847. doi: 10.1002/hed.28093. Epub 2025 Jan 31.

DOI:10.1002/hed.28093
PMID:39890747
Abstract

BACKGROUND

The role of post-operative radiotherapy (PORT) in early-stage (T1-T2N0M0) oral tongue squamous cell carcinoma (OTSCC) with minor adverse features (MAF) including perineural invasion (PNI) and poorly differentiated carcinoma (PDC) is not well described. We aimed to study the role of PORT among these patients.

METHODS

A retrospective review of patients treated for early-stage OTSCC between 2000 and 2022 in a tertiary-care referral center while comparing patients treated by surgery and PORT with patients treated by surgery alone.

RESULTS

One hundred fifty-four patients were included and 36 (23.4%) received PORT. The PORT subgroup had a significantly higher rate of MAF. Survival rates were similar between the two sub-groups. PORT demonstrated a trend toward improved overall survival (odds ratio = 0.406, p = 0.07). Patients with PNI or PDC treated with PORT experienced improved survival rates.

CONCLUSION

PORT has an important role when treating early-stage OTSCC with MAF. It should be considered especially among patients with PNI or PDC.

摘要

背景

术后放疗(PORT)在具有微小不良特征(MAF)的早期(T1-T2N0M0)口腔舌鳞状细胞癌(OTSCC)中的作用,这些微小不良特征包括神经周侵犯(PNI)和低分化癌(PDC),目前尚未得到充分描述。我们旨在研究PORT在这些患者中的作用。

方法

对2000年至2022年在一家三级医疗转诊中心接受早期OTSCC治疗的患者进行回顾性研究,同时比较接受手术加PORT治疗的患者与仅接受手术治疗的患者。

结果

纳入154例患者,其中36例(23.4%)接受了PORT。PORT亚组的MAF发生率显著更高。两个亚组的生存率相似。PORT显示出总体生存率改善的趋势(比值比=0.406,p=0.07)。接受PORT治疗的PNI或PDC患者生存率有所提高。

结论

PORT在治疗具有MAF的早期OTSCC时具有重要作用。尤其在PNI或PDC患者中应考虑使用。

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本文引用的文献

1
Impact of Postoperative Radiotherapy on the Prognosis of Early-Stage (pT1-2N0M0) Oral Tongue Squamous Cell Carcinoma.术后放疗对早期(pT1-2N0M0)口腔舌鳞状细胞癌预后的影响。
J Clin Oncol. 2024 May 20;42(15):1754-1765. doi: 10.1200/JCO.23.01106. Epub 2024 Apr 1.
2
Impact of Adjuvant Radiotherapy in Squamous Cell Carcinoma of the Oral Cavity with Perineural Invasion.辅助放疗对伴神经周围侵犯的口腔鳞状细胞癌的影响。
Laryngoscope. 2024 May;134(5):2019-2027. doi: 10.1002/lary.31148. Epub 2023 Nov 17.
3
Adjuvant radiotherapy mitigates impact of perineural invasion on oncologic outcomes in early-stage oral cavity squamous cell carcinoma. A multi-institutional analysis of 557 patients.
辅助放疗减轻了早期口腔鳞状细胞癌中神经周围侵犯对肿瘤学结果的影响。对 557 例患者的多机构分析。
Oral Oncol. 2023 Jul;142:106420. doi: 10.1016/j.oraloncology.2023.106420. Epub 2023 May 12.
4
Head and neck radiotherapy leading to extensive late oral soft-tissue necrosis.头颈部放疗导致广泛的晚期口腔软组织坏死。
Oral Oncol. 2022 Feb;125:105710. doi: 10.1016/j.oraloncology.2021.105710. Epub 2022 Jan 12.
5
Role of Adjuvant Radiotherapy in Early Stage Tongue Cancer: Need for Establishing Stringent Guidelines.辅助放疗在早期舌癌中的作用:建立严格指南的必要性。
Indian J Surg Oncol. 2021 Sep;12(3):549-553. doi: 10.1007/s13193-021-01379-5. Epub 2021 Jul 1.
6
Elective Neck Dissection, but Not Adjuvant Radiation Therapy, Improves Survival in Stage I and II Oral Tongue Cancer with Depth of Invasion >4 mm.选择性颈部清扫术而非辅助性放射治疗可提高浸润深度>4mm的I期和II期口腔舌癌患者的生存率。
Cureus. 2019 Dec 4;11(12):e6288. doi: 10.7759/cureus.6288.
7
Postoperative radiotherapy (PORT) for early oral cavity cancer (pT1-2,N0-1): A review.早期口腔癌(pT1-2,N0-1)术后放疗(PORT):综述。
Crit Rev Oncol Hematol. 2019 Nov;143:67-75. doi: 10.1016/j.critrevonc.2019.08.003. Epub 2019 Aug 31.
8
Early oral cavity cancer: The prognostic factors and impact of adjuvant radiation on survival.早期口腔癌:预后因素及辅助放疗对生存的影响。
Head Neck. 2019 Oct;41(10):3577-3583. doi: 10.1002/hed.25882. Epub 2019 Jul 24.
9
Survival benefits of adjuvant radiation in the management of early tongue cancer with depth of invasion as the indication.以浸润深度为指征的辅助放疗对早期舌癌患者生存获益的影响。
Head Neck. 2018 Oct;40(10):2263-2270. doi: 10.1002/hed.25329. Epub 2018 Jun 26.
10
The role of adjuvant treatment in early-stage oral cavity squamous cell carcinoma: An international collaborative study.辅助治疗在早期口腔鳞状细胞癌中的作用:一项国际合作研究。
Cancer. 2018 Jul 15;124(14):2948-2955. doi: 10.1002/cncr.31531. Epub 2018 May 14.