医学
倾向得分匹配
扁桃体
放射治疗
扁桃体切除术
颈淋巴结清扫术
内科学
子群分析
回顾性队列研究
癌
外科
胃肠病学
置信区间
作者
Youngkyong Kim,Kwan Ho Cho,Sung Ho Moon,Chang Geol Lee,Ki Chang Keum,Sang Wook Lee,Yong Chan Ahn,Dongryul Oh,Yeon Sil Kim,Yong Kyun Won,Hong Gyun Wu,J. Hun Hah,Young Taek Oh
出处
期刊:Cancer Research and Treatment
[Korean Cancer Association]
日期:2017-10-15
卷期号:49 (4): 1097-1105
被引量:20
摘要
Purpose The impact of postoperative ipsilateral neck radiotherapy (INRT) versus bilateral neck radiotherapy (BNRT) on the clinical outcomes of patients with tonsillar squamous cell carcinoma was analyzed retrospectively. Materials and Methods Between October 2001 and June 2012, 241 patients with T1-2 and N0-N2b tonsillar carcinoma from 16 institutes underwent postoperative INRT (n=84) or BNRT (n=157) following a tonsillectomy. Seventy patients were identified from each group by propensity score matching and compared in terms of the overall survival (OS), disease-free survival (DFS), locoregional relapse-free survival (LRRFS), and distant metastasis-free survival (DMFS) rates calculated using the Kaplan-Meier method with a log-rank test. Results The median follow-up was 55 months (range, 3 to 133 months). The survival outcomes in the INRT and BNRT groups were similar: 5-year OS (92.8% vs. 94.0%, p=0.985), DFS (80.5% vs. 94.2%. p=0.085), LRRFS (88.1% vs. 97.1%, p=0.083), and DMFS (92.7% vs. 97.0%, p=0.370). Subgroup analysis revealed no contralateral neck recurrence in 61 patients with T1-2N0-2a regardless of the treatment groups. For 79 patients with N2b, contralateral neck recurrence was more common in the INRT group than in the BNRT group (7.9% vs. 0.0%), but the difference was not significant (p=0.107). The overall grade ⥠2 toxicities were lower in the INRT group: acute (45.7% vs. 74.3%, p=0.001) and late (4.3% vs. 31.4%, p < 0.001), respectively. Conclusion INRT is an attractive strategy for patients with T1-2N0-2a tonsillar carcinoma compared to BNRT. For patients with N2b, there was a small risk of contralateral neck recurrence when treated with INRT, but its impact on the OS was limited with successful salvage treatment. Key words: Ipsilateral neck, Adjuvant radiotherapy, Tonsillar neoplasms, Radiation volume, Toxicity
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