针对头颈部癌症照射区病变的内窥镜粘膜下剥离术。

IF 3.7 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Yasuhiro Tani, Takashi Kanesaka, Kosuke Urabe, Mizuki Korematsu, Koji Kitamura, Junji Miyabe, Shinji Otozai, Tadashi Yoshii, Minoru Kato, Shunsuke Yoshii, Tomoki Michida, Ryu Ishihara, Koji Konishi, Keiichiro Honma, Takashi Fujii
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引用次数: 0

摘要

背景和目的:头颈部鳞状细胞癌照射区病变的有效治疗是一个主要问题。本研究旨在明确内镜下切除此类病变的有效性和安全性:在2014年1月至2021年12月期间,因组织学证实的头颈部鳞状细胞癌接受内镜下切除术的连续患者中,在内镜下切除术前接受过明确放疗/化放疗的患者被纳入这项单中心回顾性研究。对短期和长期疗效进行了评估:在422名接受内镜切除术治疗615个病灶的患者中,有43名患者的57个病灶符合条件。所有 57 个病灶均接受了内镜下粘膜下剥离术治疗,所有病灶均实现了全切。8例(19%)患者发生了不良事件通用毒性标准v5.0中的3级(吞咽困难,7例;狭窄,3例;吸入性肺炎,2例;咽部坏死,1例[部分病例重叠]),但没有发生≥4级的事件。有两名患者因吞咽困难和喉头坏死而暂时需要通过胃造口术进行肠内营养。内镜下粘膜下剥离术治疗照射区病变后,中位随访时间为 40 个月(四分位间范围为 29.5-61),期间分别有 2 例(5%)和 9 例(21%)患者出现局部复发和并发病变。不过,所有患者都避免了全喉切除术和气管造口术。3年总存活率和疾病特异性存活率分别为81%(95%置信区间,64%-91%)和94%(95%置信区间,79%-99%):结论:内镜粘膜下剥离术具有良好的局部控制效果和安全性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Endoscopic submucosal dissection for lesions developing in the irradiated area of head and neck cancer.

Background and aim: Effective treatment of lesions that develop in the irradiated area of head and neck squamous cell carcinoma is a major concern. This study aimed to clarify the efficacy and safety of endoscopic resection for such lesions.

Methods: Among consecutive patients who underwent endoscopic resection for histologically proven head and neck squamous cell carcinoma between January 2014 and December 2021, those who received definitive radiotherapy/chemoradiotherapy before endoscopic resection were included in this single-center, retrospective study. Short- and long-term outcomes were evaluated.

Results: Among 422 patients who underwent endoscopic resection for 615 lesions, 43 patients with 57 lesions were eligible. All 57 lesions were treated with endoscopic submucosal dissection and en bloc resection was achieved in all lesions. Grade 3 of Common Toxicity Criteria for Adverse Events v5.0 occurred in eight (19%) patients (dysphagia, seven; stricture, three; aspiration pneumonia, two; and pharyngeal necrosis, one [some cases overlapped]), but no grade ≥ 4 events occurred. Enteral nutrition by gastrostomy was temporarily required in two patients owing to dysphagia and laryngeal necrosis. During the median follow-up of 40 (interquartile range, 29.5-61) months after endoscopic submucosal dissection for the lesions developed in the irradiated area, local recurrence and metachronous lesions developed in two (5%) and nine (21%) patients, respectively. However, total laryngectomies and tracheostomies were avoided in all patients. The 3-year overall and disease-specific survivals were 81% (95% confidence interval, 64%-91%) and 94% (95% confidence interval, 79%-99%), respectively.

Conclusions: Favorable local control and safety of endoscopic submucosal dissection were demonstrated.

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来源期刊
CiteScore
7.90
自引率
2.40%
发文量
326
审稿时长
2.3 months
期刊介绍: Journal of Gastroenterology and Hepatology is produced 12 times per year and publishes peer-reviewed original papers, reviews and editorials concerned with clinical practice and research in the fields of hepatology, gastroenterology and endoscopy. Papers cover the medical, radiological, pathological, biochemical, physiological and historical aspects of the subject areas. All submitted papers are reviewed by at least two referees expert in the field of the submitted paper.
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