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罗 希, 孙 士, 徐 艺, 黄 晓, 王 凯, 吴 润, 王 静, 张 烨, 张 江, 陈 雪, 曲 媛, 罗 京, 易 俊. [Comparison of different laryngeal preservation strategies based on chemoradiotherapy in locally advanced hypopharyngeal carcinoma]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2023; 37:708-714. [PMID: 37640994 PMCID: PMC10722127 DOI: 10.13201/j.issn.2096-7993.2023.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Indexed: 08/31/2023]
Abstract
Objective:This study aimed to evaluate the clinical features and treatment outcomes of the value of response-adapted treatment following radiotherapy and induction chemotherapy follwing subsequent comprehensive therapy in patients with resectable locally advanced hypopharyngeal carcinoma. Methods:This cohort study was conducted from September 2010 to September 2020 in our hospital, 231 patients pathologically confirmed stage Ⅲ and ⅣB resectable locally advanced hypopharyngeal carcinoma included. For the IC-directed ART strategy, IC is used to select good candidates to receive radical RT or CCRT, and others undergo surgery. He response-adapted strategy was determined based on the primary tumor response, which was evaluated at a dose of 50 Gy. If the response reached complete response or partial response(more than 80% tumor regression), patients received radical RT or CCRT; otherwise, they received surgery, if possible, at 4 to 6 weeks after RT. The end points of the study were OS(overall survival), progression free survival(PFS), locoregional recurrence-free survival(LRRFS) and LDFS. Results:In IC-directed group, 75.0%(57/76) patients reached PR after 2 cycles of induction chemotherapy. While in RT-directed group, 70.3%(109/155) patients reached large PR at dose of 50 Gy. The median interquartile range follow-up period of the whole cohort was 63.8 months. The 5-year OS, PFS, LRRFS and SFL of the whole cohort were 47.9%、39.6%、44.3% and 36.2%, respectively. In evaluations based on the different treatment strategies, the 5-year OS and SFL were 51.3% versus 37.0%(HR 0.67; 95%CI 0.43-1.05; P=0.07) and 27.8% versus 39.8%(HR 0.68; 95%CI 0.46-0.99; P=0.04) between IC-directed and RT-directed groups. In additional, surgery complications did not significantly differ between these two groups. Conclusion:In this cohort study, the response-adapted strategy based on an early RT response facilitated better treatment tailoring, and higher laryngeal preservation compared with IC-directed strategies. This approach could provide a feasible laryngeal preservation strategy in patients with resectable locally advanced hypopharyngeal carcinoma.
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Affiliation(s)
- 希 罗
- 国家癌症中心 肿瘤临床研究中心 北京协和医学院中国医学科学院肿瘤医院放疗科(北京,100021)Department of Radiation Oncology National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - 士然 孙
- 国家癌症中心 肿瘤临床研究中心 北京协和医学院中国医学科学院肿瘤医院放疗科(北京,100021)Department of Radiation Oncology National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - 艺 徐
- 国家癌症中心 肿瘤临床研究中心 北京协和医学院中国医学科学院肿瘤医院放疗科(北京,100021)Department of Radiation Oncology National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - 晓东 黄
- 国家癌症中心 肿瘤临床研究中心 北京协和医学院中国医学科学院肿瘤医院放疗科(北京,100021)Department of Radiation Oncology National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - 凯 王
- 国家癌症中心 肿瘤临床研究中心 北京协和医学院中国医学科学院肿瘤医院放疗科(北京,100021)Department of Radiation Oncology National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - 润叶 吴
- 国家癌症中心 肿瘤临床研究中心 北京协和医学院中国医学科学院肿瘤医院放疗科(北京,100021)Department of Radiation Oncology National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - 静波 王
- 国家癌症中心 肿瘤临床研究中心 北京协和医学院中国医学科学院肿瘤医院放疗科(北京,100021)Department of Radiation Oncology National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - 烨 张
- 国家癌症中心 肿瘤临床研究中心 北京协和医学院中国医学科学院肿瘤医院放疗科(北京,100021)Department of Radiation Oncology National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - 江鹄 张
- 国家癌症中心 肿瘤临床研究中心 北京协和医学院中国医学科学院肿瘤医院放疗科(北京,100021)Department of Radiation Oncology National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - 雪松 陈
- 国家癌症中心 肿瘤临床研究中心 北京协和医学院中国医学科学院肿瘤医院放疗科(北京,100021)Department of Radiation Oncology National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - 媛 曲
- 国家癌症中心 肿瘤临床研究中心 北京协和医学院中国医学科学院肿瘤医院放疗科(北京,100021)Department of Radiation Oncology National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - 京伟 罗
- 国家癌症中心 肿瘤临床研究中心 北京协和医学院中国医学科学院肿瘤医院放疗科(北京,100021)Department of Radiation Oncology National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - 俊林 易
- 国家癌症中心 肿瘤临床研究中心 北京协和医学院中国医学科学院肿瘤医院放疗科(北京,100021)Department of Radiation Oncology National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
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何 美, 吴 润, 张 烨, 黄 晓, 王 凯, 陈 雪, 王 静, 曲 媛, 罗 京, 易 俊. [Clinical characteristics and efficacy of oropharyngeal carcinoma with secondary primary tumor]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2023; 37:721-728. [PMID: 37640995 PMCID: PMC10722119 DOI: 10.13201/j.issn.2096-7993.2023.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Indexed: 08/31/2023]
Abstract
Objective:To analysis the clinical features and prognosis in oropharyngeal carcinoma with secondary primary tumor. Methods:A retrospective analysis was performed on 468 pathologically confirmed oropharyngeal cancer as the primary tumor patients with p16 status, excluded distant metastasis, and admitted to the Chinese Academy of Medical Sciences from January 2010 to December 2020. The clinical features and prognosis of the secondary primary tumor were analyzed. Results:Among 468 patients with oropharyngeal cancer treated at initial diagnosed, 222 cases were P16-negative. With a median follow-up time of 64.3 months, 66 cases developed second primary cancer, with an incidence of 29.3%, among which 63.6%(42/66) were synchronous and 36.4%(24/66) were heterochronous, esophagus was the most commonly involved site. The 5-year OS of p16-negative oropharyngeal carcinoma with synchronous second primary cancer, without second primary cancer and with heterogeneous second primary cancer were 26.3% and 57.3% and 73.2%(P=0.001); The second primary cancer accounted for 11.2%(12/107) of the deaths in the whole group, among them, the heterochronous second primary accounted for 75.0%(9/12). There were 246 patients with p16 positive, with a median follow-up time of 52.4 months, 20 patients developed second primary cancer(8.1%). Among them, 65.0%(13/20) were synchronous and 35.0%(7/20) were heterochronous. Esophagus was the most commonly involved site. The 4-year OS of p16-positive with synchronous, heterochronous and non-second primary cancer group were 51.9%, 80.7% and 83.3%. Secondary primary cancer accounted for 3.8%(2/52) of all deaths in p16 positvie group. Conclusion:The incidence of second primary cancer of p16 positive and negative oropharyngeal carcinoma were different. The esophagus was the most commonly involved site regardless of p16 status. Regardless of p16 status, the survival of patients with synchronous second primary cancer was worse than those without second primary cancer. For p16-negative oropharyngeal carcinoma, the prognosis was better in patients with heterogeneous second primary cancer, the second primary cancer is one of the main causes of death.
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Affiliation(s)
- 美霖 何
- 国家癌症中心 肿瘤临床研究中心 北京协和医学院中国医学科学院肿瘤医院放疗科(北京,100021)Department of Radiation Oncology National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - 润叶 吴
- 国家癌症中心 肿瘤临床研究中心 北京协和医学院中国医学科学院肿瘤医院放疗科(北京,100021)Department of Radiation Oncology National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - 烨 张
- 国家癌症中心 肿瘤临床研究中心 北京协和医学院中国医学科学院肿瘤医院放疗科(北京,100021)Department of Radiation Oncology National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - 晓东 黄
- 国家癌症中心 肿瘤临床研究中心 北京协和医学院中国医学科学院肿瘤医院放疗科(北京,100021)Department of Radiation Oncology National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - 凯 王
- 国家癌症中心 肿瘤临床研究中心 北京协和医学院中国医学科学院肿瘤医院放疗科(北京,100021)Department of Radiation Oncology National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - 雪松 陈
- 国家癌症中心 肿瘤临床研究中心 北京协和医学院中国医学科学院肿瘤医院放疗科(北京,100021)Department of Radiation Oncology National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - 静波 王
- 国家癌症中心 肿瘤临床研究中心 北京协和医学院中国医学科学院肿瘤医院放疗科(北京,100021)Department of Radiation Oncology National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - 媛 曲
- 国家癌症中心 肿瘤临床研究中心 北京协和医学院中国医学科学院肿瘤医院放疗科(北京,100021)Department of Radiation Oncology National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - 京伟 罗
- 国家癌症中心 肿瘤临床研究中心 北京协和医学院中国医学科学院肿瘤医院放疗科(北京,100021)Department of Radiation Oncology National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - 俊林 易
- 国家癌症中心 肿瘤临床研究中心 北京协和医学院中国医学科学院肿瘤医院放疗科(北京,100021)Department of Radiation Oncology National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
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刘 利, 任 莉, 程 汉, 郭 一, 黄 晓, 周 荣. 两栖类、爬行类和鸟类存在一个新的<italic>Dmrt</italic>基因家族. Chin Sci Bull 2001. [DOI: 10.1360/csb2001-46-14-1187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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