比较口腔鳞状细胞癌（OCSCC）患者接受辅助或最终（化疗）放射治疗的生存结果和复发模式

IF 3.2 3区医学 Q2 ONCOLOGY

Clinical oncology Pub Date : 2025-04-26 DOI:10.1016/j.clon.2025.103855

K. Oguejiofor , S. Ramkumar , A.-A. Nabi , K. Moutasim , R.P. Singh , S. Sharma , M. Ethunandan , I.S. Boon

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引用次数: 0

摘要

目的评估局部晚期口腔鳞状细胞癌（LA-OCSCC）根治性手术后辅助或明确的前期（化疗）放疗的生存结局和复发模式。材料和方法这是一项英国癌症中心对治疗目的的LA-OCSCC的回顾性分析。所有在2012年至2022年间接受治疗的OCSCC患者被纳入术后辅助（化疗）放疗或最终（化疗）放疗组。在开始辅助治疗前复发的患者被排除在外。结果患者特点：首发手术加辅助（化疗）放疗99例（73.9%），最终组35例（26.1%）。生存期：辅助组和最终组的中位无进展生存期分别为17个月和15个月（P值为0.947）。辅助组和最终组的中位总生存期分别为61个月和43个月（P值为0.154）。吸烟史是生存的一个独立的负面预测因子。复发：局部和远处复发的中位时间分别为17个月和15个月。辅助治疗组局部复发率为26%，远处复发率为32%，而最终治疗组分别为26%和34%。复发率最高的是在诊断后的头两年。LA-OCSCC可以发生远端复发，而先前没有局部-区域复发。结论可手术切除的LA-OCSCC患者行原发性根治性手术后辅助（化疗）放疗比术前明确（化疗）放疗具有更好的生存结局。LA-OCSCC的复发模式是侵袭性的，没有治愈性手术，生存率较差。

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Comparing Survival Outcomes and Recurrence Patterns in Oral Cavity Squamous Cell Carcinoma (OCSCC) Patients Treated With Curative Intent Either With Adjuvant or Definitive (Chemo)radiotherapy

Aims

To assess the survival outcome and recurrence patterns of locally advanced oral cavity squamous cell carcinoma (LA-OCSCC) treated with radical surgery followed by adjuvant or definitive upfront (chemo)radiotherapy.

Materials and methods

This is a single United Kingdom cancer centre retrospective analysis on LA-OCSCC treated with curative intent. All OCSCC patients treated between 2012 and 2022 were included with groups treated with either postoperative adjuvant (chemo)-radiotherapy or definitive (chemo)radiotherapy. Patients who recurred before starting adjuvant treatments were excluded.

Results

Patient characteristics: Ninety-nine (73.9%) patients were treated with primary surgery followed by adjuvant (chemo)radiotherapy and 35 (26.1%) patients treated in the definitive group, respectively. Survival: The median progression-free survival was 17 months and 15 months for adjuvant and definitive groups, respectively (P value of 0.947). Median overall survival was 61 months and 43 months for adjuvant and definitive groups, respectively (P value of 0.154). Smoking history is an independent negative predictor for survival. Recurrence: Median time to local and distant recurrence was 17 months and 15 months, respectively. In the adjuvant group, the local recurrence rate is 26% and the distant recurrence rate is 32%, compared with the definitive group at 26% and 34%, respectively. The rate of recurrence is highest in the first two years after diagnosis. Distant recurrence in LA-OCSCC can happen without prior local-regional recurrence.

Conclusion

Patients with surgically resectable LA-OCSCC patients treated with primary radical surgery followed by adjuvant (chemo)radiotherapy had better survival outcomes compared with patients treated with upfront definitive (chemo)radiotherapy. The pattern of recurrence of LA-OCSCC is aggressive and without curative surgery the rate of survival is poorer.

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来源期刊

Clinical oncology 医学-肿瘤学

CiteScore

5.20

自引率

8.80%

发文量

332

审稿时长

40 days

期刊介绍： Clinical Oncology is an International cancer journal covering all aspects of the clinical management of cancer patients, reflecting a multidisciplinary approach to therapy. Papers, editorials and reviews are published on all types of malignant disease embracing, pathology, diagnosis and treatment, including radiotherapy, chemotherapy, surgery, combined modality treatment and palliative care. Research and review papers covering epidemiology, radiobiology, radiation physics, tumour biology, and immunology are also published, together with letters to the editor, case reports and book reviews.