医学
腺样囊性癌
放射治疗
辅助放疗
佐剂
辅助治疗
显著性差异
回顾性队列研究
多元分析
腺样体
癌
内科学
外科
核医学
癌症
作者
Yufan Yang,Juntao Ran,Yalong Wang,Zongmei Zhou,Dongfu Chen,Qinfu Feng,Jun Liang,Zefen Xiao,Zhouguang Hui,Jima Lv,Yibo Gao,Jie He,Nan Bi,Lühua Wang
出处
期刊:Lung Cancer
[Elsevier]
日期:2021-07-01
卷期号:157: 116-123
被引量:4
标识
DOI:10.1016/j.lungcan.2021.05.006
摘要
Purposes This study aimed to evaluate the role of radiotherapy (RT) and intensity modulated radiation therapy (IMRT) in adjuvant and definitive settings of tracheal-bronchial adenoid cystic carcinoma (TACC) treatment. Materials/methods TACC patients (n = 133) treated with surgery and/or RT curatively in our institution between January 1st, 1984 and December 31st, 2017 were analyzed retrospectively. Results Among the 116 patients undergoing surgery, 50 (43.1 %) achieved complete resections and 66 (56.9 %) had positive surgical margins. For patients with positive margins, overall adjuvant RT was correlated with no significantly improved OS (10-year: 58.0 % vs. 47.9 %; P = 0.340) and a slight LRFS benefit (5-year: 81.9 % vs.75.6 %; P = 0.056), but adjuvant IMRT showed significant superiority in both OS (10-year: 82.9 % vs. 47.9 %; P = 0.031) and LRFS (5-year: 100.0 % vs. 75.6 %; P = 0.001) in comparison with no postoperative RT. Multivariate analysis also identified adjuvant IMRT as a significant favorable factor with OS (HR = 0.186, 95 %CI: 0.039–0.883; P = 0.034). For 17 patients receiving definitive RT, IMRT achieved promising 5-year OS of 88.9 % and LRFS of 64.3 %, yet no significant difference from non-IMRT group was reached (P = 0.447 and 0.706). Different therapies presented no significantly different impact on DMFS, whilst DMFS explained more of the OS variances (P < 0.001, R2 = 0.480) than LRFS (P < 0.001, R2 = 0.323). Conclusion IMRT could confer greatly improved OS and LRFS in postoperative setting for TACC patients with positive surgical margins. IMRT was also a good therapeutic option for definitive TACC with promising survival and local control.
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