■对于具有不良特征的唾液腺癌(SGC),强烈建议在初次手术后进行放射治疗。手术和放疗(SRT)开始之间的间隔各不相同,延长的SRT可能会导致癌症治疗失败。然而,在主要SGC中,SRT与生存率的相关性尚不清楚.
■本回顾性研究纳入2005年至2020年复旦大学附属上海肿瘤中心一期手术后接受放疗的346例患者。通过最大对数秩统计方法确定SRT的最佳截止值。研究的主要终点是总生存期(OS)。变量与OS之间的相关性通过使用Log-rank方法进行单变量分析,进行多变量Cox比例风险回归分析,以确定与OS相关的独立预后因素.使用Kaplan-Meier方法获得估计的存活率。
■中位随访时间为70.31个月,估计的5年操作系统,LRFS,DMFS为83.3%,80.1%,75.9%,分别。SRT的截止值为8.5周,而年龄,T级,N级,神经周浸润(PNI),病理性侵略,化疗,单变量分析中SRT与OS相关。Cox回归分析表明,年龄较大(P<0.001),T3-4肿瘤(P=0.007),正N期(P<0.001),病理性攻击(P=0.014),和更长的SRT(P=0.009)是主要SGC的独立预后因素。使用分层模型,我们观察到SRT延迟与高危组的OS恶化相关(P=0.006),而在低危亚组中没有观察到显著差异(P=0.61)。
■术后放疗的延迟可能是主要SGC患者的预后因素。建议放疗应在术后8.5周内进行,特别是对于具有≥2个危险因素的患者,包括年龄较大,高度病理性侵略,T3-4肿瘤,正N阶段。
UNASSIGNED: Radiotherapy following primary operation is strongly recommended for salivary gland carcinomas (SGCs) with adverse features. The interval between surgery and the initiation of radiotherapy (SRT) varied and a prolonged SRT may cause failure of cancer treatment. However, the association of SRT with survival is unclear in major SGCs.
UNASSIGNED: This retrospective study included a total of 346 patients who underwent radiotherapy after the primary operation from Fudan University Shanghai Cancer Center from 2005 to 2020. The best cutoff value of the SRT was determined by the maximum log-rank statistic method. The primary endpoint of the study was overall survival (OS). Correlations between variables and OS were conducted by the univariable analysis using the Log-rank method, and a multivariate Cox proportional hazards regression was performed to identify the independent prognostic factors associated with OS. The estimated survival rates were captured using the Kaplan-Meier method.
UNASSIGNED: With a median follow-up time of 70.31 months, the estimated 5-year OS, LRFS, and DMFS were 83.3%, 80.1%, and 75.9%, respectively. The cutoff value for SRT was 8.5 weeks, while age, T stage, N stage, perineural invasion (PNI), pathological aggression, chemotherapy, and SRT were associated with OS in the univariable analysis. The Cox regression analysis demonstrated that older age (P < 0.001), T3-4 tumors (P = 0.007), positive N stage (P < 0.001), pathological aggression (P = 0.014), and longer SRT (P = 0.009) were independent prognostic factors for major SGCs. Using the stratification model, we observed that delay in the SRT was associated with worse OS (P = 0.006) in the high-risk group, whereas no significant difference was observed in the low-risk subgroup (P = 0.61).
UNASSIGNED: The delay in the initiation of postoperative radiotherapy may be a prognostic factor for patients with major SGCs. It was suggested that radiotherapy should be delivered within 8.5 weeks following the operation, especially for patients with ≥2 risk factors, including older age, high pathological aggression, T3-4 tumors, and positive N stage.