Impact of primary tumor-specific growth rate on treatment failure for nonropharyngeal head and neck cancers
Impact of primary tumor-specific growth rate on treatment failure for nonropharyngeal head and neck cancers
复制标题
DOI：
10.1002/lary.28393
复制
发表时间：
2019-11-12
期刊：
影响因子：
2.6
通讯作者：
Galloway, Thomas J.
中科院分区：
文献类型：
--
作者：
Roldan, Claudia S.;Chen, Jie Jane;Galloway, Thomas J.
目的探讨原发性肿瘤特异性生长率（TSGR）对非口咽鳞癌（non-OPSCC）放射治疗后疗效的影响。方法对39例非OPSCC患者的诊断肿瘤和淋巴结体积进行轮廓勾画，并与相应的RT计划扫描体积进行比较，以确定TSGR。根据Kaplan-Meier方法评价总生存期（OS）、无病生存期（DFS）和局部无复发生存期;使用考克斯回归估计风险比（HR）。基于第75百分位数的TSGR为2.18%，我们将患者分为高TSGR组（>= 2.18%/天）和低TSGR组（< 2.18%/天）。结果中位随访时间为22个月（范围：1-86个月），诊断和模拟CT扫描之间的中位时间为22天（范围：7-170天）。中位RT剂量为70戈伊（范围：60-79.2戈伊）。基于第75百分位数TSGR，高TSGR组中位随访时的OS为50.0%，而低TSGR组为92.5%（HR [95%置信区间（CI）] = 2.12[1.16-11.42]，P = 0.018）。在中位随访时，高TSGR组与低TSGR组的DFS有恶化趋势，分别为55.6%和82.3%（HR [95% CI] = 2.29[0.82-6.38]，P = 0.103）。结论我们的研究有助于增加文献TSGR作为非OPSCC患者的时间生物标志物。与TSGR低于该阈值的患者相比，TSGR >= 2.18%/天的患者的OS显著更差。努力解决治疗开始延迟可能会使具有特别侵袭性和快速生长肿瘤的患者受益。证据等级4喉镜，2019
Objectives To investigate the prognostic impact of primary tumor-specific growth rate (TSGR) on treatment outcomes after definitive radiation therapy (RT) for nonoropharyngeal squamous cell carcinoma (non-OPSCC). Methods The diagnostic tumor and nodal volumes of 39 non-OPSCC patients were contoured and compared to corresponding RT planning scan volumes to determine TSGR. Overall survival (OS), disease-free survival (DFS), and local recurrence-free survival were evaluated according to the Kaplan-Meier method; and hazard ratios (HR) were estimated using Cox regression. Based on the 75th percentile TSGR of 2.18%, we stratified patients into a high TSGR group (>= 2.18% per day) and low TSGR group (< 2.18% per day). Results The median follow-up was 22 months (range: 1-86 months) and median time between diagnostic and simulation computed tomography scans was 22 days (range: 7-170 days). Median RT dose was 70 Gy (range: 60-79.2 Gy). Based on the 75th percentile TSGR, OS at median follow-up was 50.0% for the high TSGR group compared to 92.5% for the low TSGR group (HR [95% confidence interval (CI)] = 2.12[1.16-11.42], P = 0.018). There was a trend toward worse DFS at median follow-up for the high versus low TSGR groups, at 55.6% and 82.3%, respectively (HR [95% CI] = 2.29[0.82-6.38], P = 0.103). Conclusion Our study contributes to growing literature on TSGR as a temporal biomarker in patients with non-OPSCC. Patients with high TSGR >= 2.18% per day have significantly worse OS compared to those with TSGR below this threshold. Efforts to address treatment initiation delays may benefit patients with particularly aggressive and rapidly growing tumors. Level of Evidence 4 Laryngoscope, 2019