■这项荟萃分析的目的是评估pN1口腔鳞状细胞癌患者术后放疗(PORT)的潜在益处。
■在主要数据库中进行的文献检索一直持续到2023年1月。提取并合并不同生存结果的校正风险比(aHR)或风险比(RR)和95%置信区间(CIs)。
■在2005年至2022年之间发表的10项研究,汇集了2888名患者,纳入了这项荟萃分析。由于研究设计和报告结果的差异,这些研究被分为不同的组.在没有结外延伸(ENE)的pN1患者中,PORT与总生存期(OS)的显着改善相关(aHR0.76,95%CI:0.61-0.94)。在无ENE和切缘阳性的pN1患者中,PORT改善了OS(aHR0.71,95%CI:0.56-0.89),并与较低的区域复发率(RR0.35,95%CI:0.15-0.83)相关。然而,在没有ENE的pN1患者中,正利润率,神经周浸润,和淋巴管浸润,PORT组和观察组的5年OS(RR0.48,95%CI:0.07~3.41)或5年无病生存期(RR0.37,95%CI:0.07~2.06)均无显著差异.
■目前的研究表明,PORT有可能改善pN1疾病的OS。然而,是否管理PORT的决定仍然取决于不同的临床方案,和额外的研究是必要的,以提供一个更确凿的决议。
■2.
UNASSIGNED: The aim of this meta-analysis is to evaluate the potential benefits of postoperative radiotherapy (
PORT) in patients with pN1 oral cavity squamous cell carcinoma.
UNASSIGNED: A literature search through major databases was conducted until January 2023. The adjusted hazard ratio (aHR) or risk ratio (RR) with 95% confidence intervals (CIs) of different survival outcomes were extracted and pooled.
UNASSIGNED: Ten studies published between 2005 and 2022, with a pooled patient population of 2888, were included in this meta-analysis. Due to differences in study design and reported outcomes, the studies were categorized into distinct groups. In pN1 patients without extranodal extension (ENE),
PORT was associated with a significant improvement in overall survival (OS) (aHR 0.76, 95% CI: 0.61-0.94). In pN1 patients without ENE and positive margins,
PORT improved OS (aHR 0.71, 95% CI: 0.56-0.89) and was associated with a lower regional recurrence rate (RR 0.35, 95% CI: 0.15-0.83). However, in pN1 patients without ENE, positive margins, perineural invasion, and lymphovascular invasion, there were no significant differences observed between the PORT and observation groups in either 5-year OS (RR 0.48, 95% CI: 0.07-3.41) or 5-year disease-free survival (RR 0.37, 95% CI: 0.07-2.06).
UNASSIGNED: The current study demonstrated that
PORT has the potential to improve OS in pN1 disease. However, the decision of whether to administer
PORT still hinges on diverse clinical scenarios, and additional research is necessary to furnish a more conclusive resolution.
UNASSIGNED: 2.