选定的伴有切迹上颞下窝延伸的cT4b牙槽癌亚群,采用三药新辅助化疗启动“三联方案”后的肿瘤预后

IF 0.2 Q4 MEDICINE, GENERAL & INTERNAL
Parina Patel, D. Mandlik, K. Gupta, Purvi S. Patel, N. Sharma, A. Joshipura, A. Kaushal, K. Jani, Subhadha Kanhere, Diva S. Shah, D. Shah, G. Vishwakarma, Bijay Newpane, Kaustubh D. Patel
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引用次数: 0

摘要

背景:局部晚期牙槽-肺泡复杂癌(T4b)伴乙状窦上切迹颞下窝(ITF)延伸是一种预后不佳的肿瘤挑战。我们分析了接受3种药物新辅助化疗(NACT)、手术间室切除术和辅助放疗/化疗-RT (RT/CTRT),即“三联方案”的患者的肿瘤预后。材料与方法:2009年6月至2017年1月,33例T4b牙槽-肺泡复杂癌伴ITF过切口延伸。患者接受3药NACT治疗,每21天2-3个周期。通过临床检查、症状改善(如开口改善等)和实体肿瘤反应评价标准(RECIST)来评估NACT的疗效。病情稳定且对NACT有反应的患者接受室室手术切除并完全清除ITF,然后进行辅助RT/CTRT。使用STATA 13和Kaplan - Meir图分析生存率数据。结果:31例患者(93.9%)对NACT有反应,随后继续进行手术治疗。符合RECIST标准的临床缓解18例,主观临床改善50%以上,<50% 13例。最后随访时,31例患者中有17例无疾病。ITF无复发。3年无病生存率和疾病特异性生存率分别为69%和73%。结论:选择对NACT有反应的病例进行三药NACT后手术切除,辅助放化疗为这些边缘可切除的T4b超notch病例提供了希望。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Oncological outcome following 3-drug neo-adjuvant chemotherapy initiated “Triple regimen” for selected subset of cT4b bucco-alveolar carcinoma with supra-notch infratemporal fossa extension
Background: Locally advanced bucco-alveolar complex carcinoma (T4b) with supra-notch (supra-sigmoid notch) infratemporal fossa (ITF) extension is an oncological challenge with poor outcome. We analyzed oncological outcome in patients managed with 3-drug neo-adjuvant chemotherapy (NACT) followed with surgical compartmental resection and adjuvant radiotherapy/Chemotherapy-RT (RT/CTRT), i.e., “Triple regimen.” Materials and Methods: Thirty-three cases of T4b bucco-alveolar complex carcinoma with supra-notch ITF extension were included from June 2009 to January 2017. Patients received 3-Drug NACT for 2–3 cycles every 21 days. Response to NACT was assessed with clinical examination, improvement in symptoms (like improved mouth opening etc.,), and Response Evaluation Criteria in Solid Tumors (RECIST) criterion. Patients showing stable disease and responders on NACT underwent compartmental surgical resection with complete ITF clearance followed by adjuvant RT/CTRT. Data were analyzed using STATA 13 and Kaplan − Meir graphs for survival rates. Results: Thirty-one patients (93.9%) showed response on NACT and subsequently went ahead with surgery. Clinical response according to RECIST criterion and subjective clinical improvement of more than 50% was noted in 18 cases while it was <50% in 13 cases. Seventeen of the 31 patients were disease free at last follow-up. There were no recurrences in ITF. The 3-year disease-free survival and disease-specific survival were 69% and 73%, respectively. Conclusion: Three-drug NACT followed by surgical resection in selected cases who show response to NACT with adjuvant chemoradiation provides a realm of hope for these borderline resectable T4b supra-notch cases.
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来源期刊
Journal of Head & Neck Physicians and Surgeons
Journal of Head & Neck Physicians and Surgeons MEDICINE, GENERAL & INTERNAL-
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