Doll Christian, Hofmann Elena, Trelinska-Finger Anna, Heiland Max, Letsch Anne, Knödler Maren, Beck Marcus, Klinghammer Konrad, Wittenberg Ian, Reinwald Fabian, Sackmann Andrea, Klinkhammer-Schalke Monika, Zeissig Sylke Ruth, Weitmann Kerstin, Franke Bianca, Dommerich Steffen, Schneider Constanze, Zips Daniel, Tinhofer Inge
Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, 13353 Berlin, Germany.
Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, 13353 Berlin, Germany; Berlin Institute of Health (BIH) Charité Junior Clinician Scientist Program, Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin Institute of Health Biomedical Innovation Academy, Charitéplatz 1, 10117 Berlin, Germany.
Oral Oncol. 2025 Aug;167:107384. doi: 10.1016/j.oraloncology.2025.107384. Epub 2025 Jun 2.
The benefit of adjuvant radiotherapy (RT) for patients with early-stage oral cavity squamous cell carcinoma (OSCC) or p16-negative oropharyngeal squamous cell carcinoma (OPSCC) with a solitary ipsilateral lymph node metastasis remains unclear.
A population-based analysis was conducted to assess overall survival (OS) and the incidence of locoregional recurrence (LRR) in patients diagnosed with pT1/pT2 OSCC or p16-negative OPSCC and a solitary ipsilateral lymph node metastasis without extracapsular spread (pN1) between 2017 and 2022. Information regarding clinical characteristics and outcomes was gathered from 12 clinical cancer registries in January 2024. The data were compared between those patients who underwent surgical resection alone and those who had surgery followed by adjuvant RT.
The final analysis included 526 patients, with 250 individuals receiving treatment for OSCC and 276 for p16-negative OPSCC. Of these, 230 patients (43.7 %) underwent surgical resection, and 296 (56.3 %) had surgery followed by adjuvant RT. The addition of adjuvant RT was associated with improved 5-year OS (p = 0.0079) and reduced LRR incidence (p = 0.0013). In multivariate Cox regression analysis, adjuvant RT was associated with improved OS (HR 0.49 [0.32; 0.76]) and a reduced risk of LRR (HR 0.39 [0.22; 0.69]).
This clinical cancer registry study portends an oncological benefit of adjuvant RT for patients with early-stage (pT1/pT2) OSCC and p16-negative OPSCC who present with solitary ipsilateral lymph node metastasis. This benefit was particularly notable in the sub-cohort of younger patients with p16-negative OPSCC and the sub-cohort of elderly patients with OSCC.
辅助放疗（RT）对早期口腔鳞状细胞癌（OSCC）或p16阴性的口咽鳞状细胞癌（OPSCC）且伴有孤立性同侧淋巴结转移患者的益处仍不明确。
进行了一项基于人群的分析，以评估2017年至2022年间诊断为pT1/pT2 OSCC或p16阴性OPSCC且伴有孤立性同侧淋巴结转移且无包膜外扩散（pN1）的患者的总生存期（OS）和局部区域复发（LRR）发生率。2024年1月从12个临床癌症登记处收集了有关临床特征和结局的信息。对仅接受手术切除的患者和接受手术加辅助放疗的患者的数据进行了比较。
最终分析纳入了526例患者，其中250例接受OSCC治疗，276例接受p16阴性OPSCC治疗。其中，230例患者（43.7%）接受了手术切除，296例（56.3%）接受了手术加辅助放疗。辅助放疗的加入与5年总生存期的改善（p = 0.0079）和局部区域复发率的降低（p = 0.0013）相关。在多变量Cox回归分析中，辅助放疗与总生存期的改善（风险比[HR] 0.49 [0.32；0.76]）和局部区域复发风险的降低（HR 0.39 [0.22；0.69]）相关。
这项临床癌症登记研究表明，辅助放疗对出现孤立性同侧淋巴结转移的早期（pT1/pT2）OSCC和p16阴性OPSCC患者具有肿瘤学益处。这种益处在p16阴性OPSCC的年轻患者亚组和OSCC的老年患者亚组中尤为显著。
