Treatment-related outcome of oropharyngeal cancer patients differentiated by HPV dictated risk profile: a tertiary cancer centre series analysis
Treatment-related outcome of oropharyngeal cancer patients differentiated by HPV dictated risk profile: a tertiary cancer centre series analysis
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DOI：
10.1093/annonc/mdu004
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发表时间：
2014-03-01
影响因子：
50.5
通讯作者：
Licitra, L.
中科院分区：
文献类型：
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作者：
Bossi, P.;Orlandi, E.;Licitra, L.
这项回顾性研究根据患者的风险状况评估了OPC的不同治疗方案的差异效应。总体而言，低，中风险的OPC患者有更好的生存率与开放手术后RT相比，CRT治疗。这些数据表明，不同的治疗方法可能是必不可少的，在确定结果results.To日期，没有治疗方式已被确定为更有效的口咽癌（OPC），并没有预测因素是已知的，以指导这种疾病的治疗决策。这项回顾性研究根据患者的风险状况评估了不同治疗方案对OPC的不同影响。我们考虑了两个系列的局部晚期鳞状细胞OPC患者，分别接受手术加放疗（手术系列）或化放疗（CRT）治疗，伴/不伴诱导多西他赛、顺铂和5-氟尿嘧啶（TPF）化疗（CRT系列）。分析吸烟习惯、肿瘤p16表达/人乳头瘤病毒（HPV）状态以及T和N分期，以根据Ang的风险特征（低、中和高风险）对患者进行分层。采用Kaplan-Meier法计算总生存期（OS）和无病生存期，共纳入171例患者，其中手术组56例，CRT组115例。患者分为低风险组（手术组和CRT组的20%）、中风险组（23%和41%）和高风险组（57%和39%）。在手术组中，低、中和高血管紧张素风险的5年OS分别为54.5%、46.9%和40.0%，而在CRT组中，这些分别为100%、78.9%和46.7%。在多变量分析中，调整治疗组之间的不均匀性，低风险组和中风险组的CRT效果显著更高（OS分析中相互作用治疗风险组的P值= 0.034）。在这项回顾性分析中，低风险和中风险OPC患者接受CRT治疗时的生存率高于开放手术后接受放射治疗。这些数据表明，不同的治疗方法可能是必不可少的，在确定结果的结果。
This retrospective study evaluates the differential effects of diverse treatment options for OPC according to patient risk profiles. Overall, low- and intermediate-risk OPC patients had a better survival when treated with CRT compared with open surgery followed by RT. These data suggest that different treatment approaches might be essential in determining outcome results.To date, no treatment modality has been identified as more effective for oropharyngeal cancer (OPC), and no predictive factors are known to guide treatment decision for this disease. This retrospective study evaluates the differential effects of diverse treatment options for OPC according to patient risk profiles.We considered two series of locally advanced squamous cell OPC patients treated with either surgery followed by radiotherapy (surgical series) or chemoradiation (CRT) with/without induction docetaxel, cisplatin and 5-fluorouracil (TPF) chemotherapy (CRT series). Smoking habits, tumor p16 expression/human papillomavirus (HPV) status and T and N stage were analyzed to stratify the patients according to Ang's risk profile (low, intermediate and high risk). Overall survival (OS) and disease-free survival were calculated with the Kaplan-Meier method.Globally, 171 patients were considered, 56 in surgical and 115 in CRT series. Patients were stratified in low- (20% of surgical and CRT groups), intermediate- (23% and 41%) and high-risk (57% and 39%) groups. In the surgical series, 5-year OS was 54.5%, 46.9% and 40.0% in low, intermediate and high Ang's risk profiles, respectively, whereas in the CRT series those were 100%, 78.9% and 46.7%, respectively. In the multivariable analyses, adjusting for inhomogeneity between the treatment group, the CRT effect was significantly higher in the low- and intermediate-risk groups (P-value for the interaction treatment risk group = 0.034 in the OS analysis).In this retrospective analysis, low- and intermediate-risk OPC patients had a better survival when treated with CRT compared with open surgery followed by radiation therapy. These data suggest that different treatment approaches might be essential in determining outcome results.