Kano Satoshi, Suzuki Takayoshi, Yoshida Daisuke, Tsushima Nayuta, Idogawa Hiroshi, Katsumata Ryohei, Yasuda Koichi, Kinota Naoya, Yamasaki Koji, Shimizu Yasushi, Taguchi Jun, Aoyama Hidefumi, Homma Akihiro
Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-Ku, Sapporo, 060-8638, Japan.
Diagnostic Imaging Center, Sapporo Yamanoue Hospital, Sapporo, Japan.
Int J Clin Oncol. 2025 Mar 27. doi: 10.1007/s10147-025-02751-z.
Standard treatments for locally advanced oropharyngeal cancer (OPC) include surgery and chemoradiotherapy (CRT). While surgery offers good tumor control, it often results in significant postoperative functional impairments. Conversely, intravenous chemoradiotherapy (IV-CRT) is less effective in controlling primary tumors in T4 OPC cases and offers limited options for salvage surgery after recurrence. RADPLAT, a treatment involving intra-arterial cisplatin combined with radiotherapy, has demonstrated favorable results for other cancers and may offer an alternative treatment for OPC.
This retrospective study compared the efficacy and safety of RADPLAT and IV-CRT in the patients with T4 OPC treated at Hokkaido University Hospital between 2003 and 2022. The primary endpoint was local recurrence-free survival (LRFS), and the secondary endpoint was overall survival (OS).
Fifty-six patients were included, with 29 in the RADPLAT group and 27 in the IV-CRT group. The RADPLAT group showed significantly better LRFS (2-year LRFS: 82.3%) and OS (5-year OS: 73.8%) compared to the IV-CRT group (2y-LRFS: 66.0%, 5y-OS: 45.7%). Multivariate analysis identified RADPLAT as an independent favorable prognostic factor for both LRFS and OS. There was no significant difference in the incidence of adverse events between the two groups, although grade 3 or higher mucositis was more common in the RADPLAT group. Swallowing function and tracheostomy rates were similar between the groups.
RADPLAT provides superior local control and survival outcomes compared to IV-CRT for T4 OPC, with comparable safety and functional preservation. These findings suggest that RADPLAT may be a promising alternative to IV-CRT for cases with T4 OPC.
局部晚期口咽癌（OPC）的标准治疗方法包括手术和放化疗（CRT）。虽然手术能很好地控制肿瘤，但往往会导致严重的术后功能障碍。相反，静脉放化疗（IV-CRT）在控制T4期OPC病例的原发性肿瘤方面效果较差，且复发后挽救性手术的选择有限。RADPLAT是一种动脉内注射顺铂联合放疗的治疗方法，已在其他癌症中显示出良好效果，可能为OPC提供另一种治疗选择。
这项回顾性研究比较了2003年至2022年期间在北海道大学医院接受治疗的T4期OPC患者中RADPLAT和IV-CRT的疗效和安全性。主要终点是无局部复发生存期（LRFS），次要终点是总生存期（OS）。
共纳入56例患者，其中RADPLAT组29例，IV-CRT组27例。与IV-CRT组（2年LRFS：66.0%，5年OS：45.7%）相比，RADPLAT组的LRFS（2年LRFS：82.3%）和OS（5年OS：73.8%）显著更好。多变量分析确定RADPLAT是LRFS和OS的独立有利预后因素。两组不良事件发生率无显著差异，尽管3级或更高等级的粘膜炎在RADPLAT组中更常见。两组间吞咽功能和气管切开率相似。
与IV-CRT相比，RADPLAT在T4期OPC中提供了更好的局部控制和生存结果，安全性和功能保留相当。这些发现表明，对于T4期OPC病例，RADPLAT可能是IV-CRT的一个有前景的替代方案。
