Natural course of distant metastases following radiotherapy or chemoradiotherapy in HPV-related oropharyngeal cancer
Natural course of distant metastases following radiotherapy or chemoradiotherapy in HPV-related oropharyngeal cancer
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DOI：
10.1016/j.oraloncology.2012.07.015
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发表时间：
2013-01-01
期刊：
影响因子：
4.8
通讯作者：
O'Sullivan, Brian
中科院分区：
文献类型：
--
作者：
Huang, Shao Hui;Perez-Ordonez, Bayardo;O'Sullivan, Brian
目的：描述HPV（+）口咽癌（OPC）放疗（RT）或放化疗（CRT）后远处转移（DM）的自然病程。比较HPV（+）和HPV（-）两组患者DM的自然病程。结果：中位随访时间为3.9年。HPV（+）（n = 457）与HPV（-）（n = 167）病例之间的DM率相似（3年时11% vs. 15%，p = 0.25）。虽然几乎所有（24/25）HPV（-）DM发生在RT后2年内（1例为2.1年），但7/54（13%）HPV（+）DM在3年后（长达5.3年）被检测到。18例（33%）HPV（+）发生了>2个器官的传播，而HPV（-）无。HPV（+）与HPV（-）病例的2年DM后生存率分别为11%和4%（p = 0.02）。5/6例HPV（+）伴肺寡转移的患者在DM挽救性手术后2年仍存活，病情稳定（化疗：3例;手术切除：2例;放疗：1例）。结论：虽然糖尿病发病率相似，但HPV（+）糖尿病的自然病程与HPV（-）患者不同：它可能会在较长的时间间隔后发生，通常具有“传播”表型，少数人在挽救DM后可能会延长生存期。(C)2012爱思唯尔有限公司保留所有权利。
Objectives: To describe the natural course of distant metastases (DMs) following radiotherapy (RT) or chemoradiotherapy (CRT) in HPV(+) oropharyngeal carcinoma (OPC).Methods: OPC treated with RT/CRT from 1/1/2000 to 5/31/2010 were reviewed. The natural course of DM were compared between HPV(+) and HPV(-) cohorts.Results: Median follow-up was 3.9 years. The DM rate were similar (11% vs. 15% at 3-years, p = 0.25) between the HPV(+) (n = 457) vs. the HPV(-) (n = 167) cases. While almost all (24/25) HPV(-) DM occurred within 2-years following RT (1 was at 2.1 years), 7/54 (13%) of HPV(+) DM were detected beyond 3 years (up to 5.3 years). Disseminating to >2 organs occurred in 18 (33%) HPV(+) vs. none in HPV(-). Post-DM survival rates were 11% vs. 4% at 2-years (p = 0.02) for the HPV(+) vs. HPV(-) cases respectively. 5/6 HPV(+) with lung oligo-metastasis were still alive with stable disease beyond 2-years after salvage procedures for DM (chemotherapy: 3; surgical resection: 2; radiotherapy: 1).Conclusions: Although DM rates are similar, the natural course of HPV(+) DM differs from that of HPV(-) patients: it may occur after a longer interval, often with a "disseminating" phenotype, and a small number may have prolonged survival after salvage for DM. (C) 2012 Elsevier Ltd. All rights reserved.