摘要
目的基于美国SEER数据库的资料,评估放疗对初诊转移性头颈鳞癌(HNSCC)患者预后的影响。方法利用SEER数据库筛选2010—2015年初诊为转移性HNSCC的患者1226例,包括放疗组762例(62.1%),未放疗组464例(37.9%)。采用Kaplan-Meier法计算癌症特异性生存(CSS)和总生存(OS),在全组患者中通过Cox多因素回归和倾向配比评分(PSM)评估放疗对预后的影响。依据多因素分析结果将患者分为低、中和高风险组,并在不同风险组中分析放疗对生存的影响。结果全组患者中位CSS和OS时间分别为11.0个月和10.0个月;放疗组和未放疗组的中位CSS时间分别为13.0个月和6.0个月,中位OS时间分别为12.0个月和6.0个月。多因素分析显示年龄、原发灶部位、T分期、N分期、转移脏器个数、手术、放疗和化疗是独立的预后影响因素(CSS:P值为0.045、0.021、0.001、0.002、<0.001、<0.001、<0.001、<0.001;OS:P值为0.002、<0.001、0.002、<0.001、<0.001、<0.001、<0.001、<0.001)。PSM配对后,在低、中、高风险组中,放疗和未放疗患者3年CSS分别为:62.5%∶23.5%、22.4%∶15.7%和10.5%∶9.6%(P=0.008、0.001、0.203);3年OS分别为:58.0%∶20.8%、19.8%∶12.7%和7.0%∶6.1%(P=0.002、0.001、0.166)。结论放疗显著提高低风险和中风险组患者的CSS和OS,但高风险组患者不能从放疗中生存获益。
Objective To evaluate the survival outcomes of radiotherapy in patients with newly-diagnosed metastatic head and neck squamous cell carcinoma(HNSCC)based on data from the Surveillance,Epidemiology and End Results(SEER)database.Methods A total of 1226 patients newly-diagnosed with metastatic HNSCC between 2010 and 2015 were selected from the SEER database.There were 762 patients(62.1%)in the radiotherapy group and 464 patients(37.9%)in the non-radiotherapy group.Kaplan-Meier method was used to calculate the cancer-specific survival(CSS)and overall survival(OS).The effect of radiotherapy on survival was assessed by Cox multivariate regression and Propensity score-matched analyses(PSM).According to the results of multivariate analysis,the patients were further divided into low-,intermediate-and high-risk groups,and the effect of radiotherapy on survival was analyzed in different risk groups.Results The median CSS and OS time of the whole group was 11.0 months and 10.0 months,respectively.For patients in the radiotherapy group and non-radiotherapy group,the median CSS time was 13.0 months and 6.0 months,and the median OS time was 12.0 months and 6.0 months,respectively.Multivariate analysis showed that age(CSS,P=0.045;OS,P=0.002),primary tumor site(CSS,P=0.021;OS,P<0.001),T stage(CSS,P=0.001;OS,P=0.002),N stage(CSS,P=0.002;OS,P<0.001),number of metastatic organs(CSS,P<0.001;OS,P<0.001),surgery(CSS,P<0.001;OS,P<0.001),radiotherapy(CSS,P<0.001;OS,P<0.001),and chemotherapy(CSS,P<0.001;OS,P<0.001)were the independent prognostic factors.After PSM,patients with and without radiotherapy in the low-,intermediate-,and high-risk groups,the 3-year CSS rates were 62.5%vs 23.5%(P=0.008),22.4%vs 15.7%(P=0.001)and 10.5%vs 9.6%(P=0.203),respectively;the 3-year OS were 58.0%vs 20.8%(P=0.002),19.8%vs 12.7%(P=0.001)and 7.0%vs 6.1%(P=0.166),respectively.Conclusion Radiotherapy significantly improves CSS and OS in the low-and intermediate-risk groups,but patients in the high-risk group do not benefit from radiotherapy.
作者
黄州
刘伟欣
赵丹
徐晓龙
肖绍文
郑宝敏
王维虎
孙艳
Zhou Huang;Weixin Liu;Dan Zhao;Xiaolong Xu;Shaowen Xiao;Baomin Zheng;Weihu Wang;Yan Sun(Key Laboratory of Carcinogenesis and Translational Research,Ministry of Education,Department of Radiation Oncology,Peking University Cancer Hospital&Institute,Beijing 100142,China)
出处
《中华放射肿瘤学杂志》
CSCD
北大核心
2022年第8期685-690,共6页
Chinese Journal of Radiation Oncology
基金
北京市医院管理中心“登峰”计划(DFL20220902)。
关键词
头颈鳞状细胞癌
放射疗法
肿瘤转移
Squamous cell carcinoma of head and neck
Radiotherapy
Neoplasm metastasis
