口腔癌术后放疗伴或不伴选择性颈部放疗的pN0整体解剖颈部：肿瘤预后和晚期毒性

IF 4.9 1区医学 Q1 ONCOLOGY

Radiotherapy and Oncology Pub Date : 2025-04-19 DOI:10.1016/j.radonc.2025.110896

B. Kreike , A. Al-Mamgani , E. van Werkhoven , M. Beugeling , J.H.A.M. Kaanders , M. van Ruler , P.A.H. Doornaert , M.A. de Jong , M.S. Koedijk , M.R. Vergeer , H.H.G. Verbeek , F.W.R. Wesseling , Joris B.W. Elbers , on behalf of the Dutch Head and Neck Radiation Oncology Society

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引用次数: 0

摘要

背景与目的口腔癌患者整体原发肿瘤合并颈部清扫术后，选择性术后放疗（PORT）对pN0颈部的益处尚不清楚。这项全国性的多中心回顾性观察性研究调查了增加或减少选择性颈部照射对原发肿瘤床PORT的影响。材料和方法收集了来自荷兰12个头颈癌中心的治疗数据，以比较两组患者的肿瘤预后和长期毒性，即PORT体积仅涉及原发肿瘤床（PORT- t， 118例）和pN0颈部同时照射原发肿瘤床（PORT- tn， 146例）。结果中位随访60个月后，两组患者5年区域控制率均为96%。PORT-T组和PORT-TN组的5年局部控制率分别为92%和91%，5年总生存率分别为80%和78% (p值>；0.05)。多变量分析显示，pN0颈部选择性放疗与晚期2-3级口干症显著相关(OR 4,93, p <；0.01)和吞咽困难(OR 5.29, p <；0.01)。结论口腔癌患者不进行pN0整体解剖颈部的选择性放疗，其局部控制率与接受颈部随原发肿瘤床选择性放疗的患者相当，可显著减少晚期2-3级放疗相关的口干和吞咽困难。因此，可以安全地忽略pN0整体解剖颈部的选择性照射。

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Postoperative radiotherapy for oral cavity cancer with or without elective neck radiotherapy of the pN0 en bloc dissected neck: oncologic outcomes and late toxicity

Background and purpose

The benefit of elective postoperative radiotherapy (PORT) to the pN0 neck after en bloc primary tumor with neck dissection in patients with oral cavity cancer remains unclear. This nationwide multicenter retrospective observational study investigates the effect of adding or omitting elective neck irradiation to PORT of the primary tumor bed.

Materials and Methods

Treatment data from 12 head and neck cancer centers in the Netherlands was pooled to compare oncologic outcomes and long-term toxicity between 2 groups of patients, i.e. in whom the PORT volume involved the primary tumor bed only (PORT-T, 118 patients) and in whom the pN0 neck was also irradiated, along with the primary tumor bed (PORT-TN, 146 patients).

Results

After a median follow-up of 60 months, 5-year regional control was 96 % in both groups. The 5-year local control was 92 % vs 91 % and the 5-year overall survival was 80 % vs 78 % for the PORT-T and PORT-TN group, respectively (p-value > 0.05 for all). Multivariable analyses showed that elective irradiation of pN0 neck was significantly associated with late grade 2–3 xerostomia (OR 4,93, p < 0.01) and dysphagia (OR 5.29, p < 0.01).

Conclusion

The omission of elective radiotherapy to the pN0 en bloc dissected neck in patients with oral cavity cancer resulted in comparable regional control rate to those who received elective irradiation of the neck along with the primary tumor bed with a significant reduction of late grade 2–3 radiation-related xerostomia and dysphagia. Therefore, elective irradiation of the pN0 en bloc dissected neck can safely be omitted.

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来源期刊

Radiotherapy and Oncology 医学-核医学

CiteScore

10.30

自引率

10.50%

发文量

2445

审稿时长

45 days

期刊介绍： Radiotherapy and Oncology publishes papers describing original research as well as review articles. It covers areas of interest relating to radiation oncology. This includes: clinical radiotherapy, combined modality treatment, translational studies, epidemiological outcomes, imaging, dosimetry, and radiation therapy planning, experimental work in radiobiology, chemobiology, hyperthermia and tumour biology, as well as data science in radiation oncology and physics aspects relevant to oncology.Papers on more general aspects of interest to the radiation oncologist including chemotherapy, surgery and immunology are also published.