HPV阳性口咽鳞癌(OPSCC)对患者预后良好,然而,近30%的患者会经历疾病复发。我们试图详细说明失败的模式,相关的抢救治疗,以及复发性HPV阳性OPSCC患者的结局。
这是2002年至2014年复发性HPV阳性OPSCC照射患者的单机构回顾性研究。主要研究结果是总生存期(OS,使用Kaplan-Meier方法计算)。次要目标包括首次失败的模式以及挽救治疗的描述性细节。孤立性复发定义为单部位复发的初始表现(原发性,颈部或寡转移),多位点定义为局部和区域和/或多个远处复发位点。使用对数秩检验比较生存结果。
该队列由132名患者组成。存活患者的中位随访时间为59个月。估计2年和5年OS率分别为47%和32%,分别。单独组和多站点组的2年和5年OS率分别为65%和46%和19%和9%,分别(p<.001)。
复发性HPV阳性OPSCC患者的5年生存率约为32%。然而,“孤立”复发的患者,包括原发部位的疾病,颈部或寡转移部位有更有利的长期结局。
HPV-positive oropharyngeal squamous cell carcinoma (OPSCC) carries a favorable prognosis for patients, yet nearly 30% of patients will experience disease relapse. We sought to detail patterns of failure, associated salvage therapy, and outcomes for patients with recurrent HPV-positive OPSCC.
This is a single institution retrospective study of patients with recurrent HPV-positive OPSCC irradiated from 2002 to 2014. The primary study outcome was overall survival (OS, calculated using the Kaplan-Meier method). Secondary aims included patterns of first failure with descriptive details of salvage therapy. Solitary recurrences were defined as initial presentation of recurrence in a single site (primary, neck or oligometastatic), and multi-site was defined as local and regional and/or multiple sites of distant recurrence. Survival outcomes were compared using the log-rank test.
The cohort consisted of 132 patients. The median follow-up was 59 months for surviving patients. Estimated 2-year and 5-year OS rates were 47% and 32%, respectively. Comparative 2-year and 5-year OS rates were 65% and 46% versus 19% and 9% for the solitary group and multi-site group, respectively (p < .001).
Patients with recurrent HPV-positive OPSCC experience 5-year survival of approximately 32%. However, patients with a \"solitary\" recurrence including disease at the primary site, neck or oligometastatic site have more favorable long-term outcomes.