口咽癌少转移性复发检测及最终放射治疗（化疗）结果相关因素

IF 4 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology Pub Date : 2025-04-17 DOI:10.1016/j.oraloncology.2025.107310

Revadhi C Chelvarajah , Ye Liu , Jie Su , Ali Hosni Abdalaty , Scott Bratman , B.C. John Cho , Ezra Hahn , Andrew Hope , John Kim , Brian O’Sullivan , Jolie Ringash , C. Jillian Tsai , John Waldron , Anna Spreafico , Enrique Sanz Garcia , David Goldstein , Christopher Yao , Li Tong , Shao Hui Huang , Andrew McPartlin

{"title":"口咽癌少转移性复发检测及最终放射治疗（化疗）结果相关因素","authors":"Revadhi C Chelvarajah , Ye Liu , Jie Su , Ali Hosni Abdalaty , Scott Bratman , B.C. John Cho , Ezra Hahn , Andrew Hope , John Kim , Brian O’Sullivan , Jolie Ringash , C. Jillian Tsai , John Waldron , Anna Spreafico , Enrique Sanz Garcia , David Goldstein , Christopher Yao , Li Tong , Shao Hui Huang , Andrew McPartlin","doi":"10.1016/j.oraloncology.2025.107310","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose/Background</h3><div>We aim to describe characteristics and patterns of detection of distant metastasis (DM) and subsequent outcomes following definitive (chemo)radiotherapy [(C)RT] for oropharyngeal cancer (OPC).</div></div><div><h3>Material/Methods</h3><div>OPC patients who developed DM after initial complete response to (C)RT from 2010 to 2020 were included. DM were classified as oligometastases (≤5 lesions) vs polymetastases. Interval from prior normal surveillance imaging to DM detection was recorded. Multivariable analysis (MVA) was performed for overall survival (OS) after DM.</div></div><div><h3>Results</h3><div>A total of 124 patients were eligible. Most (116/124, 94 %) developed DMs within the thorax, of whom 72 (58 %) had thorax only DM. Oligometastases (n = 46) vs polymetastases (n = 78) were more commonly detected without DM-related symptoms (76 % vs 55 %, p = 0.003) and identified with shorter interval from previous normal imaging (median 7.9 vs 12.7 months, p = 0.030). Median follow-up from DM diagnosis was 31.5 months. Three-year OS after DM was higher for patients with oligometastases vs polymetastases (32 % vs 5 %, p < 0.001). Patients with oligometastases who received salvage therapy had a longer 3-year OS (vs not) (63 % vs 7 %, p < 0.001). On MVA, salvage therapy (Hazard Ratio [HR) 0.32, p = 0.005), HPV + status (HR 0.50, p = 0.002) and thorax only distant metastases (HR 0.64, p = 0.034) were associated with longer OS.</div></div><div><h3>Conclusions</h3><div>Nearly one-third of first DM in OPC following initial complete response to (C)RT are oligometastases and most occur within the thorax. Most oligometastases are asymptomatic and more commonly detected following a shorter surveillance scan interval. DM-targeted salvage therapy for oligometastases is associated with longer OS. Prospective studies refining surveillance algorithms to increase detection of oligometastases in asymptomatic high-risk OPC patients are indicated.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"165 ","pages":"Article 107310"},"PeriodicalIF":4.0000,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Factors associated with detection of oligometastatic recurrence and outcome following definitive (Chemo)radiotherapy for oropharyngeal carcinoma\",\"authors\":\"Revadhi C Chelvarajah , Ye Liu , Jie Su , Ali Hosni Abdalaty , Scott Bratman , B.C. John Cho , Ezra Hahn , Andrew Hope , John Kim , Brian O’Sullivan , Jolie Ringash , C. Jillian Tsai , John Waldron , Anna Spreafico , Enrique Sanz Garcia , David Goldstein , Christopher Yao , Li Tong , Shao Hui Huang , Andrew McPartlin\",\"doi\":\"10.1016/j.oraloncology.2025.107310\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Purpose/Background</h3><div>We aim to describe characteristics and patterns of detection of distant metastasis (DM) and subsequent outcomes following definitive (chemo)radiotherapy [(C)RT] for oropharyngeal cancer (OPC).</div></div><div><h3>Material/Methods</h3><div>OPC patients who developed DM after initial complete response to (C)RT from 2010 to 2020 were included. DM were classified as oligometastases (≤5 lesions) vs polymetastases. Interval from prior normal surveillance imaging to DM detection was recorded. Multivariable analysis (MVA) was performed for overall survival (OS) after DM.</div></div><div><h3>Results</h3><div>A total of 124 patients were eligible. Most (116/124, 94 %) developed DMs within the thorax, of whom 72 (58 %) had thorax only DM. Oligometastases (n = 46) vs polymetastases (n = 78) were more commonly detected without DM-related symptoms (76 % vs 55 %, p = 0.003) and identified with shorter interval from previous normal imaging (median 7.9 vs 12.7 months, p = 0.030). Median follow-up from DM diagnosis was 31.5 months. Three-year OS after DM was higher for patients with oligometastases vs polymetastases (32 % vs 5 %, p < 0.001). Patients with oligometastases who received salvage therapy had a longer 3-year OS (vs not) (63 % vs 7 %, p < 0.001). On MVA, salvage therapy (Hazard Ratio [HR) 0.32, p = 0.005), HPV + status (HR 0.50, p = 0.002) and thorax only distant metastases (HR 0.64, p = 0.034) were associated with longer OS.</div></div><div><h3>Conclusions</h3><div>Nearly one-third of first DM in OPC following initial complete response to (C)RT are oligometastases and most occur within the thorax. Most oligometastases are asymptomatic and more commonly detected following a shorter surveillance scan interval. DM-targeted salvage therapy for oligometastases is associated with longer OS. Prospective studies refining surveillance algorithms to increase detection of oligometastases in asymptomatic high-risk OPC patients are indicated.</div></div>\",\"PeriodicalId\":19716,\"journal\":{\"name\":\"Oral oncology\",\"volume\":\"165 \",\"pages\":\"Article 107310\"},\"PeriodicalIF\":4.0000,\"publicationDate\":\"2025-04-17\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Oral oncology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1368837525001393\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"DENTISTRY, ORAL SURGERY & MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Oral oncology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1368837525001393","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"DENTISTRY, ORAL SURGERY & MEDICINE","Score":null,"Total":0}

引用次数: 0

摘要

目的/背景我们的目的是描述口咽癌（OPC）晚期（化疗）放疗[(C)RT]后远处转移（DM）检测的特征和模式以及随后的结果。材料/方法纳入2010年至2020年对(C)RT初步完全缓解后发展为DM的sopc患者。DM分为少转移（≤5个病灶）和多转移。记录从先前正常监测成像到DM检测的时间间隔。采用多变量分析（MVA）对dm后的总生存期（OS）进行分析。大多数（116/124,94%）患者在胸腔内发展为DM，其中72例（58%）患者仅患有胸腔DM。少转移（n = 46）与多转移（n = 78）患者更常在没有DM相关症状的情况下被发现（76%对55%，p = 0.003），并且与先前正常影像学检查间隔较短（中位7.9对12.7个月，p = 0.030）。诊断为糖尿病后的中位随访时间为31.5个月。低转移患者与多转移患者相比，糖尿病后3年OS更高(32% vs 5%, p <；0.001)。接受补救性治疗的低转移患者有更长的3年OS (63% vs 7%, p <；0.001)。在MVA中，挽救性治疗（危险比[HR] 0.32, p = 0.005）、HPV +状态（危险比[HR] 0.50, p = 0.002）和仅胸腔远处转移（危险比[HR] 0.64, p = 0.034）与较长的生存期相关。结论：在(C)放疗后完全缓解的OPC患者中，近三分之一的首次DM为低转移灶，且大多数发生在胸部。大多数低转移是无症状的，在较短的监测扫描间隔后更常被发现。针对寡转移瘤的dm挽救治疗与更长的生存期相关。建议进行前瞻性研究，改进监测算法，以增加无症状高风险OPC患者的低转移灶检测。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Factors associated with detection of oligometastatic recurrence and outcome following definitive (Chemo)radiotherapy for oropharyngeal carcinoma

Purpose/Background

We aim to describe characteristics and patterns of detection of distant metastasis (DM) and subsequent outcomes following definitive (chemo)radiotherapy [(C)RT] for oropharyngeal cancer (OPC).

Material/Methods

OPC patients who developed DM after initial complete response to (C)RT from 2010 to 2020 were included. DM were classified as oligometastases (≤5 lesions) vs polymetastases. Interval from prior normal surveillance imaging to DM detection was recorded. Multivariable analysis (MVA) was performed for overall survival (OS) after DM.

Results

A total of 124 patients were eligible. Most (116/124, 94 %) developed DMs within the thorax, of whom 72 (58 %) had thorax only DM. Oligometastases (n = 46) vs polymetastases (n = 78) were more commonly detected without DM-related symptoms (76 % vs 55 %, p = 0.003) and identified with shorter interval from previous normal imaging (median 7.9 vs 12.7 months, p = 0.030). Median follow-up from DM diagnosis was 31.5 months. Three-year OS after DM was higher for patients with oligometastases vs polymetastases (32 % vs 5 %, p < 0.001). Patients with oligometastases who received salvage therapy had a longer 3-year OS (vs not) (63 % vs 7 %, p < 0.001). On MVA, salvage therapy (Hazard Ratio [HR) 0.32, p = 0.005), HPV + status (HR 0.50, p = 0.002) and thorax only distant metastases (HR 0.64, p = 0.034) were associated with longer OS.

Conclusions

Nearly one-third of first DM in OPC following initial complete response to (C)RT are oligometastases and most occur within the thorax. Most oligometastases are asymptomatic and more commonly detected following a shorter surveillance scan interval. DM-targeted salvage therapy for oligometastases is associated with longer OS. Prospective studies refining surveillance algorithms to increase detection of oligometastases in asymptomatic high-risk OPC patients are indicated.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Oral oncology 医学-牙科与口腔外科

CiteScore

8.70

自引率

10.40%

发文量

505

审稿时长

20 days

期刊介绍： Oral Oncology is an international interdisciplinary journal which publishes high quality original research, clinical trials and review articles, editorials, and commentaries relating to the etiopathogenesis, epidemiology, prevention, clinical features, diagnosis, treatment and management of patients with neoplasms in the head and neck. Oral Oncology is of interest to head and neck surgeons, radiation and medical oncologists, maxillo-facial surgeons, oto-rhino-laryngologists, plastic surgeons, pathologists, scientists, oral medical specialists, special care dentists, dental care professionals, general dental practitioners, public health physicians, palliative care physicians, nurses, radiologists, radiographers, dieticians, occupational therapists, speech and language therapists, nutritionists, clinical and health psychologists and counselors, professionals in end of life care, as well as others interested in these fields.