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Abstract：
OBJECTIVE: The objective of the study was to assess the effectiveness and toxicity of platinum-based adjuvant chemoradiotherapy (POCRT) in comparison to postoperative radiotherapy (PORT) in patients with head and neck adenoid cystic carcinoma (HNACC).
METHODS: This retrospective study analyzed patients diagnosed with HNACC at our center between January 2010 and April 2020. A 1:1 propensity score matching method was used to create a matched cohort.
RESULTS: In this study, 206 patients were analyzed, with 147 patients (71.4%) receiving postoperative radiotherapy (PORT) and 59 patients (28.6%) receiving POCRT. Twenty-one patients experienced local-regional failure. The 3-, 5-, and 10-yr local-regional control (LRC) rate for the cohort were 92.0%, 90.6%, and 86.9%, respectively. In both the entire cohort and the matched cohort, the POCRT group exhibited superior LRC compared to the PORT group (Gray\'s test, all P < 0.05*). Multivariate analysis identified adjuvant concurrent chemotherapy as an independent prognostic factor for LRC (Competing risks regression, HR = 0.144, 95% CI 0.026-0.802, P = 0.027*). In addition, the POCRT group had higher incidences of upper gastrointestinal toxicity and hematologic toxicities, including leukopenia, neutropenia, and anemia (all P < 0.05*).
CONCLUSIONS: In terms of reducing locoregional failures in HNACC patients, POCRT may potentially offer a more effective therapeutic approach than using PORT alone, although it also entails an augmented burden of treatment-related toxicity.
METHODS: This retrospective study analyzed patients diagnosed with HNACC at our center between January 2010 and April 2020. A 1:1 propensity score matching method was used to create a matched cohort.
RESULTS: In this study, 206 patients were analyzed, with 147 patients (71.4%) receiving postoperative radiotherapy (PORT) and 59 patients (28.6%) receiving POCRT. Twenty-one patients experienced local-regional failure. The 3-, 5-, and 10-yr local-regional control (LRC) rate for the cohort were 92.0%, 90.6%, and 86.9%, respectively. In both the entire cohort and the matched cohort, the POCRT group exhibited superior LRC compared to the PORT group (Gray\'s test, all P < 0.05*). Multivariate analysis identified adjuvant concurrent chemotherapy as an independent prognostic factor for LRC (Competing risks regression, HR = 0.144, 95% CI 0.026-0.802, P = 0.027*). In addition, the POCRT group had higher incidences of upper gastrointestinal toxicity and hematologic toxicities, including leukopenia, neutropenia, and anemia (all P < 0.05*).
CONCLUSIONS: In terms of reducing locoregional failures in HNACC patients, POCRT may potentially offer a more effective therapeutic approach than using PORT alone, although it also entails an augmented burden of treatment-related toxicity.
摘要：
目的：本研究的目的是评估铂类辅助放化疗（POCRT）与术后放疗（PORT）对头颈部腺样囊性癌（HNACC）患者的疗效和毒性。
方法：这项回顾性研究分析了2010年1月至2020年4月在我们中心诊断为HNACC的患者。使用1:1倾向评分匹配方法来创建匹配的队列。
结果：在这项研究中，206例患者进行了分析，147例(71.4%)接受术后放疗(PORT),59例(28.6%)接受POCRT。21名患者经历了局部区域失败。3、5-,该队列的10年局部区域控制率(LRC)为92.0%，90.6%,86.9%,分别。在整个队列和匹配的队列中，与PORT组相比，POCRT组表现出更好的LRC(Gray\'stest，所有P<0.05*)。多因素分析确定辅助同步化疗是LRC的独立预后因素(竞争风险回归，HR=0.144，95%CI0.026-0.802，P=0.027*）。此外,POCRT组有较高的上消化道毒性和血液学毒性的发生率，包括白细胞减少症,中性粒细胞减少症,贫血（均P<0.05*）。
结论：在减少HNACC患者的局部失败方面，POCRT可能提供比单独使用PORT更有效的治疗方法，尽管它也会增加治疗相关毒性的负担。
方法：这项回顾性研究分析了2010年1月至2020年4月在我们中心诊断为HNACC的患者。使用1:1倾向评分匹配方法来创建匹配的队列。
结果：在这项研究中，206例患者进行了分析，147例(71.4%)接受术后放疗(PORT),59例(28.6%)接受POCRT。21名患者经历了局部区域失败。3、5-,该队列的10年局部区域控制率(LRC)为92.0%，90.6%,86.9%,分别。在整个队列和匹配的队列中，与PORT组相比，POCRT组表现出更好的LRC(Gray\'stest，所有P<0.05*)。多因素分析确定辅助同步化疗是LRC的独立预后因素(竞争风险回归，HR=0.144，95%CI0.026-0.802，P=0.027*）。此外,POCRT组有较高的上消化道毒性和血液学毒性的发生率，包括白细胞减少症,中性粒细胞减少症,贫血（均P<0.05*）。
结论：在减少HNACC患者的局部失败方面，POCRT可能提供比单独使用PORT更有效的治疗方法，尽管它也会增加治疗相关毒性的负担。
