PDF(Pubmed)
Abstract：
BACKGROUND: De-escalation strategies for newly-diagnosed p16-positive oropharyngeal squamous cell carcinoma (p16+ OPSCC), aim to reduce treatment-related morbidity without compromising disease control. One strategy is neoadjuvant cisplatin and docetaxel chemotherapy (NAC + S) before transoral robotic surgery, with pathology-based risk-adapted adjuvant treatment.
METHODS: We examined the recurrence-free survival (RFS) for patients who received NAC + S.
RESULTS: Comparing outcomes in 103 patients between 2008 and 2023, 92% avoided adjuvant treatment and showed significantly higher 2-year recurrence-free survival (RFS) compared to those with adjuvant treatment (95.9% vs. 43.8%, p = 0.0049) CONCLUSION: Our findings suggest that pathology-based risk-adapted omission of adjuvant treatment following NAC + S does not appear to elevate recurrence risk and that NAC may identify patients with favorable tumor biology, yielding a 2-year RFS probability exceeding 95% without adjuvant treatment. Further, the study identifies a patient subset experiencing disease recurrence despite triple modality therapy. Despite limitations, including a retrospective design and modest sample size, the data advocate for controlled NAC + S studies.
METHODS: We examined the recurrence-free survival (RFS) for patients who received NAC + S.
RESULTS: Comparing outcomes in 103 patients between 2008 and 2023, 92% avoided adjuvant treatment and showed significantly higher 2-year recurrence-free survival (RFS) compared to those with adjuvant treatment (95.9% vs. 43.8%, p = 0.0049) CONCLUSION: Our findings suggest that pathology-based risk-adapted omission of adjuvant treatment following NAC + S does not appear to elevate recurrence risk and that NAC may identify patients with favorable tumor biology, yielding a 2-year RFS probability exceeding 95% without adjuvant treatment. Further, the study identifies a patient subset experiencing disease recurrence despite triple modality therapy. Despite limitations, including a retrospective design and modest sample size, the data advocate for controlled NAC + S studies.
摘要：
背景：新诊断的p16阳性口咽鳞状细胞癌（p16+OPSCC）的降阶梯策略，目的是在不影响疾病控制的情况下降低与治疗相关的发病率。一种策略是经口机器人手术前的新辅助顺铂和多西他赛化疗（NAC+S），以病理学为基础的风险适应辅助治疗。
方法：我们检查了接受NAC+S的患者的无复发生存期（RFS）。
结果：比较2008年至2023年103例患者的结果，92％的患者避免了辅助治疗，并且与辅助治疗的患者相比，2年无复发生存率（RFS）明显更高（95.9％vs.43.8%,p=0.0049）结论：我们的发现表明，在NAC+S之后，基于病理学的风险适应的辅助治疗的省略似乎不会增加复发风险，并且NAC可以识别具有良好肿瘤生物学特性的患者。在没有辅助治疗的情况下，2年RFS概率超过95%。Further,该研究确定了一个尽管接受了三联疗法治疗但仍有疾病复发的患者亚组.尽管有局限性,包括回顾性设计和适度的样本量，受控NAC+S研究的数据倡导者。
方法：我们检查了接受NAC+S的患者的无复发生存期（RFS）。
结果：比较2008年至2023年103例患者的结果，92％的患者避免了辅助治疗，并且与辅助治疗的患者相比，2年无复发生存率（RFS）明显更高（95.9％vs.43.8%,p=0.0049）结论：我们的发现表明，在NAC+S之后，基于病理学的风险适应的辅助治疗的省略似乎不会增加复发风险，并且NAC可以识别具有良好肿瘤生物学特性的患者。在没有辅助治疗的情况下，2年RFS概率超过95%。Further,该研究确定了一个尽管接受了三联疗法治疗但仍有疾病复发的患者亚组.尽管有局限性,包括回顾性设计和适度的样本量，受控NAC+S研究的数据倡导者。
