Long-term Locoregional Control With Unilateral Radiation for AJCC-7 T1-2N2b Tonsillar Cancer.
Long-term Locoregional Control With Unilateral Radiation for AJCC-7 T1-2N2b Tonsillar Cancer.
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AJCC-7 T1-2N2b 扁桃体癌的单侧放射长期局部控制。
DOI：
10.1097/coc.0000000000000940
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
Takiar,Vinita
中科院分区：
文献类型：
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作者：
Frankart,AndrewJ;Abana,ChikeO;Geier,Natalie;Bahig,Houda;Manzar,GoharShahwar;Garden,AdamS;Phan,Jack;Takiar,Vinita
目的：单侧放射治疗颈部结节已被用作侧化良好的扁桃体癌的降级策略。这种方法对于多个同侧结节的疗效尚未确定。研究假设是单侧放射治疗美国癌症联合委员会(AJCC)-7T1-2N2b扁桃体癌患者的对侧结节失败率较低。材料和方法：本研究回顾了2个学术机构接受单侧放射治疗的AJCC-7T1-2N2b扁桃体癌患者的临床资料。主要终点是对侧结节失败率。局部区域控制、总存活率和胃造瘘管放置的需要是额外的终点。结果：研究队列包括在2005年至2016年期间接受治疗的66名患者。中位随访期为80.9个月，对侧结节衰竭发生率为3.0%(2/66)，分别为4.1和20.9个月。两名患者都接受了抢救治疗，并获得了长期生存。两年和五年的总体局部区域控制率为93.9%，未达到控制持续时间的中位数。5年生存率为92.4%。结论：AJCC-7T1-2N2b扁桃体癌采用单侧放射治疗，对侧淋巴结损失率低。这一结果表明，对于同侧结节负荷相对较高的患者，考虑单侧放射治疗是安全的。
Objectives:Unilateral radiation to cervical nodes has been used as a de-escalation strategy in well-lateralized tonsil cancers. The efficacy of this approach with multiple ipsilateral nodes is not established. The study hypothesis was that unilateral radiation for American Joint Committee on Cancer (AJCC)-7 T1-2N2b tonsillar cancer results in a low rate of contralateral nodal failure.Materials and Methods:This study was a retrospective chart review of patients with AJCC-7 T1-2N2b tonsillar cancer from 2 academic institutions who were treated with unilateral radiation. The primary endpoint was the contralateral nodal failure rate. Locoregional control, overall survival, and the need for gastrostomy tube placement were additional endpoints.Results:The study cohort included 66 patients treated between 2005 and 2016. The median follow-up time was 80.9 months; contralateral nodal failure occurred in 2/66 (3.0%) patients at 4.1 and 20.9 months, respectively. Both patients underwent salvage treatment with long-term subsequent survival. Overall locoregional control at both 2 and 5 years was 93.9% and the median duration of control was not reached. Overall survival at 5 years was 92.4%.Conclusions:The use of unilateral radiation for AJCC-7 T1-2N2b tonsillar cancer resulted in low rates of contralateral nodal failure. This outcome demonstrates the safety of considering unilateral radiation treatment in patients with a relatively high ipsilateral nodal burden.