■尽管低分化在头颈部鳞状细胞癌(HNSCC)中很少见,局部复发和远处转移(DS)发生率高,预后较差。因此,本研究希望对分化差患者的不同治疗方案进行前瞻性临床研究,探索更适合这些患者的治疗方案。
■本研究为前瞻性队列研究。我们选择了喉或下咽低分化癌患者(I-IV期,T1-4a,N0-2,M0)。I-II期患者的干预治疗方法如下:手术,诱导化疗(IC)+手术,手术+辅助治疗;III-IV期患者的干预治疗方法如下:手术,IC+手术+辅助治疗,手术+辅助治疗。患者随访至少1年,并统计疾病进展和生存率。
■从2016年9月至2020年10月,纳入62例患者(I/II期29例,III/IV期33例)。我们发现,在I/II期患者中,治疗组之间的生存期没有显着差异[总生存期(OS):P=0.447;无进展生存期(PFS):P=0.504],但手术+辅助治疗组在3年OS上有显著优势(100%).在III/IV期患者中,DS有显著差异,不同治疗组之间的OS和PFS(DS:P=0.013;OS:P=0.021;PFS:P=0.020)。其中,IC+手术+辅助治疗组生存率最好,3年OS为78%。
■我们的研究发现,术后放疗可能会提高早期(I/II期)低分化HNSCC患者的OS率;对于晚期(III/IV期)患者,手术联合IC和术后辅助放疗可以更好地控制DS,提高生存率。然而,我们的研究基于小样本数据得出了上述结论,我们将继续总结和扩大样本量进行验证。
UNASSIGNED: Although poorly differentiated is rare in head and neck squamous cell carcinoma (HNSCC), its prognosis are worse with high rate of local recurrence and distant metastasis (DS). Therefore, this
study hopes to carry out prospective clinical research on different treatment options for poorly differentiated patients and explore the treatment scheme more suitable for these patients.
UNASSIGNED: This
study is a prospective cohort
study. We selected patients with poorly differentiated carcinoma in larynx or hypopharynx (stage I-IV, T1-4a, N0-2, M0). The intervention treatment methods for stage I-II patients are as follows: surgery, induction chemotherapy (IC) + surgery, surgery + adjuvant therapy; The intervention treatment methods for stage III-IV patients are as follows: surgery, IC + surgery + adjuvant therapy, surgery + adjuvant therapy. The patients were followed up for at least 1 year, and the disease progression and survival were counted.
UNASSIGNED: From September 2016 to October 2020, 62 patients were included (29 patients in stage I/II and 33 patients in stage III/IV). We found that there was no significant difference in survival between treatment groups in stage I/II patients [overall survival (OS): P=0.447; progression free survival (PFS): P=0.504], but the surgery + adjuvant treatment group had a significant advantage in 3-year OS (100%). In stage III/IV patients, there were significant differences in DS, OS and PFS between different treatment groups (DS: P=0.013; OS: P=0.021; PFS: P=0.020). Among them, the survival rate of IC + surgery + adjuvant treatment group was the best, with 3-year OS of 78%.
UNASSIGNED: Our
study found that postoperative radiotherapy may improve the OS rate of patients with early (stage I/II) poorly differentiated HNSCC; For advanced patients (stage III/IV), surgery combined with IC and postoperative adjuvant radiotherapy may better control DS and improve the survival rate. However, our
study draws the above conclusions based on small sample data, and we will continue to summarize and expand the sample size for verification.