Praneet C Kaki, Aman M Patel, Afash Haleem, Akash R Patel, Rohini Bahethi, David W Wassef, Paul T Cowan, Richard Chan Woo Park
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Multivariable binary logistic and Cox regression models were implemented.</p><p><strong>Results: </strong>Of 738 patients satisfying inclusion criteria, 379 (51.4%) underwent aRT. Oral cavity primary site (aOR 0.64, 95% CI 0.43-0.96) was associated with lower odds of undergoing aRT (p < 0.05); neck dissection (aOR 1.58, 95% CI 1.09-2.28) and PSM (aOR 1.84, 95% CI 1.30-2.60) were associated with higher odds of undergoing aRT (p < 0.025). Patients undergoing aRT had higher 5-year (94% vs. 86%) and 10-year OS (85% vs. 73%) than those not undergoing aRT (p < 0.001). Adjusting for patient demographics, pathologic features, and treatment, age at diagnosis (aHR 1.05, 95% CI 1.02-1.08, p < 0.001) was associated with worse OS; aRT (aHR 0.30, 95% CI 0.13-0.69, p = 0.005) was associated with higher OS.</p><p><strong>Conclusion: </strong>Approximately half of patients with pT1-2N0M0 HNAdCC did not undergo aRT, highlighting a possible deviation from evidence-based recommendations and an opportunity for quality improvement in the multidisciplinary care of patients. aRT was associated with higher 5-year and 10-year OS, suggesting that patients with lower-staged, node-negative HNAdCC should be offered aRT to optimize long-term survival.</p><p><strong>Level of evidence: 4: </strong></p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2000,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Adjuvant Radiotherapy in pT1-2N0M0 Head and Neck Adenoid Cystic Carcinoma.\",\"authors\":\"Praneet C Kaki, Aman M Patel, Afash Haleem, Akash R Patel, Rohini Bahethi, David W Wassef, Paul T Cowan, Richard Chan Woo Park\",\"doi\":\"10.1002/lary.32156\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Evidence regarding the indications and survival benefit of adjuvant radiotherapy (aRT) in pT1-2N0M0 head and neck adenoid cystic carcinoma (HNAdCC) is inconclusive. 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Patients undergoing aRT had higher 5-year (94% vs. 86%) and 10-year OS (85% vs. 73%) than those not undergoing aRT (p < 0.001). Adjusting for patient demographics, pathologic features, and treatment, age at diagnosis (aHR 1.05, 95% CI 1.02-1.08, p < 0.001) was associated with worse OS; aRT (aHR 0.30, 95% CI 0.13-0.69, p = 0.005) was associated with higher OS.</p><p><strong>Conclusion: </strong>Approximately half of patients with pT1-2N0M0 HNAdCC did not undergo aRT, highlighting a possible deviation from evidence-based recommendations and an opportunity for quality improvement in the multidisciplinary care of patients. aRT was associated with higher 5-year and 10-year OS, suggesting that patients with lower-staged, node-negative HNAdCC should be offered aRT to optimize long-term survival.</p><p><strong>Level of evidence: 4: </strong></p>\",\"PeriodicalId\":49921,\"journal\":{\"name\":\"Laryngoscope\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2025-03-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Laryngoscope\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/lary.32156\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"MEDICINE, RESEARCH & EXPERIMENTAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Laryngoscope","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/lary.32156","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}
引用次数: 0
摘要
背景：关于pT1-2N0M0头颈部腺样囊性癌（HNAdCC）辅助放疗（aRT）的适应症和生存获益的证据尚无定论。因此，低分期、淋巴结阴性的HNAdCC是一种罕见的、中等风险的疾病类别，根据患者和医生的偏好，辅助管理的差异很大。我们的研究调查了aRT对这种罕见、中等风险疾病类别的总生存率（OS）的影响。方法：回顾性分析2006年至2018年国家癌症数据库中pT1-2N0M0 HNAdCC患者的资料。采用多变量二元logistic和Cox回归模型。结果：738例符合纳入标准的患者中，379例（51.4%）接受了aRT治疗。口腔原发部位（aOR 0.64, 95% CI 0.43-0.96）与接受抗逆转录病毒治疗的几率较低相关(p结论：大约一半的pT1-2N0M0 HNAdCC患者未接受抗逆转录病毒治疗，突出了可能偏离循证建议和提高患者多学科护理质量的机会。aRT与较高的5年和10年OS相关，提示分期较低、淋巴结阴性的HNAdCC患者应给予aRT以优化长期生存率。证据等级：4；
Adjuvant Radiotherapy in pT1-2N0M0 Head and Neck Adenoid Cystic Carcinoma.
Background: Evidence regarding the indications and survival benefit of adjuvant radiotherapy (aRT) in pT1-2N0M0 head and neck adenoid cystic carcinoma (HNAdCC) is inconclusive. Lower-staged, node-negative HNAdCC therefore represents a rare, moderate-risk disease category with high variation in adjuvant management depending on patient and physician preferences. Our study investigates the impact of aRT on overall survival (OS) in this rare, moderate-risk disease category.
Methods: The 2006 to 2018 National Cancer Database was retrospectively reviewed for patients with pT1-2N0M0 HNAdCC. Multivariable binary logistic and Cox regression models were implemented.
Results: Of 738 patients satisfying inclusion criteria, 379 (51.4%) underwent aRT. Oral cavity primary site (aOR 0.64, 95% CI 0.43-0.96) was associated with lower odds of undergoing aRT (p < 0.05); neck dissection (aOR 1.58, 95% CI 1.09-2.28) and PSM (aOR 1.84, 95% CI 1.30-2.60) were associated with higher odds of undergoing aRT (p < 0.025). Patients undergoing aRT had higher 5-year (94% vs. 86%) and 10-year OS (85% vs. 73%) than those not undergoing aRT (p < 0.001). Adjusting for patient demographics, pathologic features, and treatment, age at diagnosis (aHR 1.05, 95% CI 1.02-1.08, p < 0.001) was associated with worse OS; aRT (aHR 0.30, 95% CI 0.13-0.69, p = 0.005) was associated with higher OS.
Conclusion: Approximately half of patients with pT1-2N0M0 HNAdCC did not undergo aRT, highlighting a possible deviation from evidence-based recommendations and an opportunity for quality improvement in the multidisciplinary care of patients. aRT was associated with higher 5-year and 10-year OS, suggesting that patients with lower-staged, node-negative HNAdCC should be offered aRT to optimize long-term survival.
期刊介绍：
The Laryngoscope has been the leading source of information on advances in the diagnosis and treatment of head and neck disorders since 1890. The Laryngoscope is the first choice among otolaryngologists for publication of their important findings and techniques. Each monthly issue of The Laryngoscope features peer-reviewed medical, clinical, and research contributions in general otolaryngology, allergy/rhinology, otology/neurotology, laryngology/bronchoesophagology, head and neck surgery, sleep medicine, pediatric otolaryngology, facial plastics and reconstructive surgery, oncology, and communicative disorders. Contributions include papers and posters presented at the Annual and Section Meetings of the Triological Society, as well as independent papers, "How I Do It", "Triological Best Practice" articles, and contemporary reviews. Theses authored by the Triological Society’s new Fellows as well as papers presented at meetings of the American Laryngological Association are published in The Laryngoscope.
• Broncho-esophagology
• Communicative disorders
• Head and neck surgery
• Plastic and reconstructive facial surgery
• Oncology
• Speech and hearing defects
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