Importance of the treatment package time in surgery and postoperative radiation therapy for squamous carcinoma of the head and neck
Importance of the treatment package time in surgery and postoperative radiation therapy for squamous carcinoma of the head and neck
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DOI：
10.1002/hed.10038
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发表时间：
2002-02-01
影响因子：
2.9
通讯作者：
Machtay, M
中科院分区：
文献类型：
--
作者：
Rosenthal, DI;Liu, L;Machtay, M
背景资料。目的探讨治疗时间相关因素对局部晚期头颈部鳞状细胞癌(SCCHN)手术加术后放射治疗(FIT)患者预后的影响。对1992年至1997年连续行SCCHN手术和术后适合度(大于或等于55GY)的208例患者进行了回顾性分析。考虑的治疗时间因素是(1)从手术到FIT开始的间隔；(2)FIT持续时间；和(3)从手术到FIT完成的总时间(治疗包时间)。治疗包时间被分为短(小于或等于100天)和长(100天)两组。其他被考虑的变量包括临床和病理分期、切缘状态、合适的剂量和肿瘤部位。根据是否符合RTOG 95-01标准，患者也被分为中危和高危两组。进行单因素(Logank)和多变量分析。存活患者的中位随访期为24个月。精算2年区域控制率(LRC)和生存率分别为82%和71%。在单变量分析中，与！高危人群(p=.011)、边缘状况(p=.038)、病理分期(p=.035)、临床N期(p=.006)、包装时间(p=.013)和合适的治疗时间(p=.03)是较高的局部失败率。在单变量分析中，包装时间也是生存的重要预测因素(p=.021)。另外两个单独的时间因素，肿瘤因素和合适的剂量没有显著意义。风险状态和治疗包时间都是LRC多变量模型中的重要因素。总治疗包时间为
Background. To determine the effect of treatment time-related factors on outcome in patients treated with surgery and postoperative radiation therapy (FIT) for locally advanced squamous cell carcinoma of head and neck (SCCHN).Methods. A retrospective review was performed on 208 consecutive patients treated from 1992 to 1997 with surgery and postoperative FIT (greater than or equal to55 Gy) for SCCHN. The treatment time factors considered were (1) interval from surgery to the start of FIT; (2) FIT duration; and (3) the total time from surgery to completion of FIT (treatment package time). Treatment package time was dichotomized into short (less than or equal to100 days) vs long (>100 days) categories. Other variables considered were clinical and pathologic staging, margin status, FIT dose, and tumor site. Patients were also divided into intermediate- and high-risk groups on the basis of eligibility for RTOG 95-01. Univariate (logrank) and multivariate analyses were performed.Results. Median follow-up for surviving patients was 24 months. Actuarial 2-year locoregional control (LRC) and survival rates were 82% and 71%, respectively. In univariate analysis, factors associated with! higher locoregional failure were high-risk group (p =.011), margin status (p =.038), pathologic stage (p =.035), clinical N stage (p =.006), package time (p =.013), and FIT treatment time (p =.03). Package time was also a significant predictor of survival in univariate analysis (p =.021). The other two individual time factors, tumor factors, and FIT dose were not significant. Both risk status: and treatment package time were significant factors in a multivariate model of LRC.Conclusions. A total treatment package time of