Abstract：
This study proposes a scoring system for adjuvant irradiation for stage I/II oral squamous cell carcinoma (OSCC). Derivation cohort (119 patients, operated between 2011 and 2014) and a validation cohort (204 patients, operated between 2016 and 2019) were included. In derivation cohort, on univariate analysis, tumor size >2 cm [3-year Disease Free Survival (DFS) 72.5% vs 95.6%, P = 0.039], lymphovascular invasion (58.3% vs 83.6%, P = 0.024), perineural invasion (75% vs 85.6%, P = 0.013), and depth of invasion ≥0.5 cm (73.8% vs 97.5%, P = 0.017) predicted 3-year DFS. Tongue lesions and poor differentiation were added as poor prognosticators based on previously published reports. Patients were grouped as low risk (<3 risk factors) and high risk (≥3 risk factors), with only high-risk group receiving adjuvant irradiation in validation cohort. Overall, 47/119 (39.5%) patients in the derivation cohort and 50/204 (24.5%) patients in validation cohort received adjuvant irradiation. In derivation cohort, 3-year DFS was 93% and 72.5% in the low and high-risk group, respectively. 3-year DFS was 90.7% and 85.8% in the low and high-risk group, respectively for validation cohort. The proposed scoring system reduced the use of adjuvant irradiation by 38%, with similar DFS.
摘要：
本研究提出了I/II期口腔鳞状细胞癌（OSCC）辅助照射的评分系统。衍生队列（119例患者，在2011年至2014年期间手术)和验证队列(204例患者，2016年至2019年期间运营)。在派生队列中，在单变量分析中，肿瘤大小>2cm[3年无病生存率（DFS）72.5%vs95.6%，P=0.039],淋巴管浸润（58.3%vs83.6%，P=0.024),神经周浸润（75%vs85.6%，P=0.013),侵入深度≥0.5cm(73.8%vs97.5%,P=0.017)预测3年DFS。根据先前发表的报告，将舌头病变和分化不良作为不良预后指标。将患者分为低风险（<3个危险因素）和高风险（≥3个危险因素）。验证队列中只有高危人群接受辅助照射。总的来说,衍生队列中47/119（39.5%）患者和验证队列中50/204（24.5%）患者接受辅助照射。在派生队列中，3年DFS在低和高风险组中分别为93％和72.5％，分别。3年DFS在低和高危组分别为90.7%和85.8%,分别用于验证队列。拟议的评分系统将辅助照射的使用减少了38%，类似的DFS。
