Lancet Oncol:口咽鳞状细胞癌的放疗与经口机器人手术和颈淋巴结清除术比较

2019-09-01 AlexYang MedSci原创

在美国,经口机器人手术(TORS)和颈淋巴结清除术已经代替了放疗,并且是口咽鳞状细胞癌(OPSCC)的最常见治疗方法,然而,并没有随机试验来比较上述疗法的效果。最近,有研究人员评估了1年治疗后的生活质量(QOL)差异情况。研究包括了68名患者并随机分配到2个小组(每组34人),时间为2012年8月10号到2017年6月9号。放疗组平均的跟踪调查时间为25个月(IQR20-33),TORS加颈淋巴结

在美国,经口机器人手术(TORS)和颈淋巴结清除术已经代替了放疗,并且是口咽鳞状细胞癌(OPSCC)的最常见治疗方法,然而,并没有随机试验来比较上述疗法的效果。最近,有研究人员评估了1年治疗后的生活质量(QOL)差异情况。

研究包括了68名患者并随机分配到2个小组(每组34人),时间为2012年8月10号到2017年6月9号。放疗组平均的跟踪调查时间为25个月(IQR20-33),TORS加颈淋巴结清除术组平均跟踪调查的时间为29个月(23-43)。治疗后1年时MDADI总评分在放疗组为86.9 (SD 11.4),而在TORS加颈淋巴结清除术组中为80.1 (13.0)(p=0.042)。另外,在放疗组中,嗜中性白血球减少症(6/34 vs 0/34)、听力损失(13 vs 5)和耳鸣(12 vs 2)比TORS加颈淋巴结清除术组明显更多,而TORS加颈淋巴结清除术组中牙关紧闭症要比放疗组更多(9 vs 1)。在放疗组中,最常见的副作用为吞咽困难(6例)、听力损失(6例)和粘膜炎(4例)且均为3级;而在TORS加颈淋巴结清除术组中为吞咽困难(9例,均为3级)。另外,TORS中有1例因失血死亡。

最后,研究人员指出,放疗患者表现出了1年治疗后更好的吞咽相关生活质量评分,尽管差异并没有达到临床显著性。另外,在2个小组中的毒性模式也不同。OPSCC患者也应该知晓上述2种治疗选择。

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    2020-05-27 howi
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    2019-10-13 minlingfeng
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    2019-09-03 sodoo
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    2019-09-03 xue8602
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    2019-09-02 anti-cancer

    谢谢梅斯分享这么多精彩信息

    0

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口咽癌是发生于软腭、腭扁桃体、舌根、会厌周围及咽壁等部位的恶性肿瘤。口咽部鳞癌易发生溃疡,多为质硬,边缘隆起不规则、基底呈凹凸不平的浸润肿块,溃疡面波及整个肿瘤区。

Lancet:西妥昔单抗vs顺铂治疗HPV阳性口咽鳞状细胞癌

研究认为,西妥昔单抗治疗HPV阳性口咽鳞状细胞癌的效果劣于顺铂