局部晚期口腔及口咽鳞癌新辅助治疗与手术优先治疗对照分析  

A comparative analysis of neoadjuvant therapy versus upfront surgery for locally advanced oral and oropharyngeal squamous cell carcinoma

作　　者：刘乾 张杰[2] LIU Qian;ZHANG Jie(Department of Maxillofacial Surgery,Peking University Stomatological Hospital,Beijing 100081)

机构地区：[1]北京大学口腔医院,100081 [2]北京大学口腔医学院·口腔医院口腔颌面外科、国家口腔疾病临床医学研究中心、口腔数字化医疗技术和材料国家工程实验室、口腔数字医学北京市重点实验室

出　　处：《现代口腔医学杂志》2024年第3期207-211,共5页Journal of Modern Stomatology

摘　　要：目的通过回顾性对照分析接受免疫治疗结合化疗新辅助治疗和手术优先治疗的局部晚期口腔及口咽鳞癌患者的临床资料,探索免疫治疗结合化疗新辅助治疗对患者的临床获益。方法选取本院2021年6月至2022年12月接受免疫治疗联合化疗新辅助治疗和手术优先治疗的局部晚期口腔及口咽鳞癌患者作为研究对象进行随访,收集两组患者的临床资料并对比两组患者的预后、术式、术后并发症发生率等指标。结果纳入符合条件患者93例,试验组33例,对照组60例,接受新辅助治疗的患者主要病理缓解率为54.5%,3至4级不良反应发生率为6%,试验组中位随访时间23个月,对照组中位随访时间17个月,两组总生存期(P>0.05)及无病生存期(P>0.05)无显著性差异,试验组手术时长、术中出血量、手术费用、术后住院天数以及使用大型皮瓣修复数量明显少于对照组(P<0.05),而气管切开率和术后并发症方面,两组无显著性差异。结论免疫治疗联合化疗新辅助治疗具有较好的安全性和有效性,可以在不影响患者预后的前提下缩短手术时间,减小手术创伤。Objective The aim of this retrospective analysis is to investigate the survival and surgery benefits of combining neoadjuvant immunotherapy with chemotherapy in patients with locally advanced oral and oropharyngeal squamous cell carcinoma,by evaluating the clinical data of patients who received this combined treatment alongside upfront surgery.Methods Patients diagnosed with locally advanced oral and oropharyngeal squamous cell carcinoma,who underwent neoadjuvant chemoimmunotherapy or upfront surgery at our hospital between June 2021 and December 2022,were selected as the study cohort.The clinical data from both groups were collected to compare surgical indicators and prognosis.Results A total of 93 eligible patients were enrolled,including 33 in the experimental group and 60 in the control group.After neoadjuvant therapy,the major pathological response rate was 54.5%,with a 6%incidence of grade 3-4 adverse reactions.The trial group had a median follow-up time of 23 months,while the control group had a median follow-up time of 17 months.In terms of surgical outcomes,the experimental group exhibited significantly reduced operation time,intraoperative blood loss,operation cost,postoperative hospital days and number of large flap repairs compared to the control group.However,there were no significant differences in tracheotomy rate and postoperative complications between the two groups.Conclusion The findings of this study demonstrate the safety and feasibility of neoadjuvant therapy combining immunotherapy and chemotherapy.This treatment strategy can effectively decrease the duration of the surgery and reduce surgical trauma,while maintaining an unaltered prognosis.

关 键 词：鳞状细胞癌 新辅助治疗 免疫治疗 口腔癌 口咽癌 

分 类 号：R739.8[医药卫生—肿瘤]