Prognostic potential of mid-treatment nodal response in oropharyngeal squamous cell carcinoma.

Prognostic potential of mid-treatment nodal response in oropharyngeal squamous cell carcinoma.
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口咽鳞状细胞癌中治疗淋巴结反应的预后潜力。

DOI:
10.1002/hed.26467
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发表时间:
2020-09-21
期刊:
Head & neck
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中科院分区:
其他
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我们研究了口咽癌(OPX)放射治疗的中期淋巴结反应对预后的影响。在44例同时接受化疗的结节阳性OPX患者中,分别在第1、10、20和35天用锥形束CT测量了结节体积。中位随访17个月,2年无瘤生存率(DFS)、局部控制率(LRC)、无远处转移生存率(DMFS)和总生存率(OS)分别为87%、92%、89%和92%。D20时ND-≥为43%的患者与D20-ND<43%的患者相比,LRC有改善(100%对78.4%,P=.03)。多因素分析显示,D20≥为43%是喉癌的独立预后因素(HR1.17,P=0.05)。低风险口咽癌患者在治疗第20天时,≥的ND为43%,患者的喉癌显著改善。ND的预后益处可能有助于确定治疗降级的候选者。
We examine the prognostic implications of mid-course nodal response in oropharyngeal cancer (OPX) to radiation therapy. In 44 patients with node-positive OPX undergoing concurrent chemoradiation, nodal volumes were measured on cone beam CTs from days 1, 10, 20, and 35. Nodal decrease (ND) was based on percent shrinkage from day 1. At a median follow-up of 17 months, the 2-year disease-free survival (DFS), locoregional control (LRC), distant metastasis-free survival (DMFS), and overall survival (OS) were 87%, 92%, 89%, and 92%, respectively. Patients with ND ≥43% at D20 had improved LRC (100% vs 78.4%, P = .03) compared to D20 ND <43%. On multivariate analysis, D20 ≥43% was independently prognostic for LRC (HR 1.17, P = .05). Patients with low-risk oropharynx cancer with ND of ≥43% by treatment day 20 had significantly improved LRC. The prognostic benefit of ND may assist in identifying candidates for treatment de-escalation.
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