The Role of Postoperative Radiation Therapy in Early-stage Tongue Carcinoma. A Systematic Review and Meta-analysis.

IF 2.2 3区医学 Q2 Dentistry

Journal of Stomatology Oral and Maxillofacial Surgery Pub Date : 2024-12-11 DOI:10.1016/j.jormas.2024.102192

Shiwang Yuan, Jiayi Chen, Guangyi Cheng, Sijia Deng, Jiang Wang, Bo Wang, Liantao Li

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引用次数: 0

Abstract

Although the overall prognosis for early-stage oral tongue squamous cell carcinoma is good, a significant portion of patients still experience locoregional recurrence and affect the disease-specific survival. At present, whether more aggressive postoperative radiation therapy in this particular patient population should be taken is still controversial. The analysis exhibited that disease-free survival (OR=0.53, 95% CI:0.35-0.81; P=0.003) and locoregional recurrence-free survival (OR=0.59, 95% CI:0.38-0.93; P=0.022) was significant improved in patients received radiotherapy compared to surgery alone. However, radiotherapy failed to improve overall survival (HR=1.06 95% CI:0.42-2.64, P=0.901). Furthermore, two studies reported overall survival based on depth of invasion as well. The pooled OR was 1.65 (95% CI:0.31-8.91, P=0.221) and no survival benefit was observed for early-stage patients underwent adjuvant radiotherapy according to depth of invasion. Current evidence is insufficient to independently support the depth of invasion as an effective indication for radiotherapy of early tongue cancer.

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虽然早期口腔舌鳞状细胞癌的总体预后良好，但仍有相当一部分患者会出现局部复发，影响疾病的特异性生存。目前，对这一特殊患者群体是否应采取更积极的术后放疗仍存在争议。分析显示，与单纯手术相比，接受放疗的患者无病生存率（OR=0.53，95% CI：0.35-0.81；P=0.003）和无局部复发生存率（OR=0.59，95% CI：0.38-0.93；P=0.022）显著提高。然而，放疗未能改善总生存率（HR=1.06 95% CI：0.42-2.64，P=0.901）。此外，有两项研究还报告了基于浸润深度的总生存率。汇总的OR值为1.65（95% CI:0.31-8.91，P=0.221），根据侵犯深度进行辅助放疗的早期患者未观察到生存获益。目前的证据不足以独立支持将浸润深度作为早期舌癌放疗的有效指征。

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来源期刊

Journal of Stomatology Oral and Maxillofacial Surgery Dentistry-Oral Surgery

CiteScore

2.20

自引率

9.10%

发文量

305

期刊介绍： J Stomatol Oral Maxillofac Surg publishes research papers and techniques - (guest) editorials, original articles, reviews, technical notes, case reports, images, letters to the editor, guidelines - dedicated to enhancing surgical expertise in all fields relevant to oral and maxillofacial surgery: from plastic and reconstructive surgery of the face, oral surgery and medicine, … to dentofacial and maxillofacial orthopedics. Original articles include clinical or laboratory investigations and clinical or equipment reports. Reviews include narrative reviews, systematic reviews and meta-analyses. All manuscripts submitted to the journal are subjected to peer review by international experts, and must: Be written in excellent English, clear and easy to understand, precise and concise; Bring new, interesting, valid information - and improve clinical care or guide future research; Be solely the work of the author(s) stated; Not have been previously published elsewhere and not be under consideration by another journal; Be in accordance with the journal''s Guide for Authors'' instructions: manuscripts that fail to comply with these rules may be returned to the authors without being reviewed. Under no circumstances does the journal guarantee publication before the editorial board makes its final decision. The journal is indexed in the main international databases and is accessible worldwide through the ScienceDirect and ClinicalKey Platforms.