RESUMEN
Objetivo Presentar los resultados del tratamiento con radioterapia en pacientes con carcinomas de orofaringe. Material y métodos Estudio retrospectivo de una cohorte de 359 pacientes tratados con radioterapia, incluyendo quimio- y bio-radioterapia, durante el periodo 2000-2019. Se dispuso de información del estatus del virus del papiloma humano (VPH) para 202 pacientes, de los que un 26,2% resultaron VPH-positivos. Resultados La supervivencia libre de recidiva local a los 5 años fue del 73,5% (IC 95%: 68,8-78,2%). Las variables que se relacionaron con el control local de la enfermedad en un estudio multivariante fueron la categoría de extensión local del tumor y el estatus VPH. La supervivencia libre de recidiva local a los 5 años para los pacientes con tumores cT1 fue del 90,0%, para los cT2 del 88,0%, para los cT3 del 70,6% y para los cT4 del 42,3%. La supervivencia libre de recidiva local a los 5 años para los tumores VPH-negativos fue del 67,2% y para los VPH-positivos del 93,3%. La supervivencia específica a los 5 años fue del 64,4% (IC 95%: 59,1-69,7%). Las variables que se relacionaron con la supervivencia específica en un estudio multivariante fueron el estado general del paciente, la extensión local y regional del tumor, y el estatus VPH. Conclusiones La supervivencia libre de recidiva local a los 5 años de los pacientes con carcinomas de orofaringe tratados con radioterapia fue del 73,5%. Las variables que se relacionaron con el control local fueron la extensión local del tumor y el estatus VPH. (AU)
Objective To present the results of radiotherapy treatment in patients with oropharyngeal carcinomas. Material and methodsRetrospective study of a cohort of 359 patients treated with radiotherapy, including chemo- and bio-radiotherapy, during the period 2000-2019. Information on human papillomavirus (HPV) status was available for 202 patients, of whom 26.2% were HPV-positive. Results Five-year local recurrence-free survival was 73.5% (95% CI: 68.8-78.2%). The variables that were related to local disease control in a multivariate study were the local tumor extension category and the HPV status. Five-year local recurrence-free survival for patients with cT1 tumors was 90.0%, for cT2 88.0%, for cT3 70.6%, and for cT4 42.3%. Five-year local recurrence-free survival for HPV-negative tumors was 67.2% and for HPV-positive tumors 93.3%. Five-year specific-disease survival was 64.4% (95% CI: 59.1-69.7%). Variables that were related to specific survival in a multivariate study were the patient's general condition, local and regional extent of the tumor, and HPV status. Conclusions Five-year local recurrence-free survival of patients with oropharyngeal carcinomas treated with radiotherapy was 73.5%. Variables that were related to local control were local tumor extension and HPV status. (AU)
Asunto(s)
Humanos , Radioterapia , Neoplasias Orofaríngeas , Estudios RetrospectivosRESUMEN
FNDC4 gene encodes the fibronectin type III domain-containing 4 protein. Elevated expression of FNDC4 has been associated with poor prognosis in several types of cancer. There are no studies that have evaluated the prognostic capacity of FNDC4 in patients with head and neck cancer (HNSCC). The aim of our study was to analyze the relationship between the transcriptional expression of FNDC4 and prognosis in HNSCC patients.MethodsWe determined the transcriptional expression of FNDC4 in 67 patients with advanced-stage HNSCC (IIIIV) treated with chemoradiotherapy. The FNDC4 expression was categorized according to the disease-specific survival with a recursive partitioning analysis.ResultsThere were significant differences in disease-specific survival as a function of the level of FNDC4 transcriptional expression. The 5-year disease-specific survival for patients with high FNDC4 expression (n = 44, 65.7%) was 32.9% (95% CI: 16.549.3%), and for patients with low expression (n = 23, 34.3%) it was 85.4% (95% CI: 70.2100%) (P = 0.0001). Patients with a high FNDC4 expression had poorer local (P = 0.097), regional (P = 0.008), and distant (0.034) recurrence-free survival. The results of a multivariate analysis showed that patients with a high FNDC4 expression had a 6.15-fold increased risk of death as a consequence of the HNSCC (95% CI: 1.7122.06).ConclusionFNCF4 transcriptional expression was significantly related to the disease-specific survival of HNSCC patients treated with chemoradiotherapy. Patients with elevated FNDC4 expression had a significant decrease in disease-specific survival. (AU)