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Chinese Journal of Radiation Oncology  2022, Vol. 31 Issue (8): 685-690    DOI: 10.3760/cma.j.cn113030-20220425-00149
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The effect of radiotherapy on survival in newly‐diagnosed metastatic head and neck squamous cell carcinoma(HNSCC)
Huang Zhou, Liu Weixin, Zhao Dan, Xu Xiaolong, Xiao Shaowen, Zheng Baomin, Wang Weihu, Sun Yan
Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Beijing 100142, China
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Abstract  Objective To evaluate the survival outcomes of radiotherapy in patients with newly‐diagnosed metastatic head and neck squamous cell carcinoma (HNSCC) based on data from the Surveillance, Epidemiology and End Results(SEER) database. Methods A total of 1226 patients newly‐diagnosed with metastatic HNSCC between 2010 and 2015 were selected from the SEER database. There were 762 patients (62.1%) in the radiotherapy group and 464 patients (37.9%) in the non‐radiotherapy group. Kaplan‐Meier method was used to calculate the cancer‐specific survival (CSS) and overall survival (OS). The effect of radiotherapy on survival was assessed by Cox multivariate regression and Propensity score‐matched analyses (PSM). According to the results of multivariate analysis, the patients were further divided into low‐, intermediate‐ and high‐risk groups, and the effect of radiotherapy on survival was analyzed in different risk groups. Results The median CSS and OS time of the whole group was 11.0 months and 10.0 months, respectively. For patients in the radiotherapy group and non‐radiotherapy group, the median CSS time was 13.0 months and 6.0 months, and the median OS time was 12.0 months and 6.0 months, respectively. Multivariate analysis showed that age (CSS, P=0.045;OS, P=0.002), primary tumor site (CSS, P=0.021;OS, P<0.001), T stage (CSS, P=0.001;OS, P=0.002), N stage (CSS, P=0.002;OS, P<0.001), number of metastatic organs (CSS, P<0.001;OS, P<0.001), surgery (CSS, P<0.001;OS, P<0.001), radiotherapy (CSS, P<0.001;OS, P<0.001), and chemotherapy (CSS, P<0.001;OS, P<0.001)were the independent prognostic factors. After PSM, patients with and without radiotherapy in the low‐,intermediate‐,and high‐risk groups, the 3‐year CSS rates were 62.5% vs 23.5%(P=0.008), 22.4% vs 15.7%(P=0.001)and 10.5% vs 9.6%(P=0.203), respectively; the 3‐year OS were 58.0% vs 20.8%(P=0.002), 19.8% vs 12.7%(P=0.001)and 7.0% vs 6.1%(P=0.166), respectively. Conclusion Radiotherapy significantly improves CSS and OS in the low‐ and intermediate‐risk groups, but patients in the high‐risk group do not benefit from radiotherapy.
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Articles by authors
Huang Zhou
Liu Weixin
Zhao Dan
Xu Xiaolong
Xiao Shaowen
Zheng Baomin
Wang Weihu
Sun Yan
Key wordsSquamous cell carcinoma of head and neck      Radiotherapy      Neoplasm metastasis     
Received: 25 April 2022     
Fund:Beijing Hospitals Authority's Ascent Plan(DFL20220902)
Corresponding Authors: Sun Yan, Email: lisaysun@139.com   
Cite this article:   
Huang Zhou,Liu Weixin,Zhao Dan et al. The effect of radiotherapy on survival in newly‐diagnosed metastatic head and neck squamous cell carcinoma(HNSCC)[J]. Chinese Journal of Radiation Oncology, 2022, 31(8): 685-690.
Huang Zhou,Liu Weixin,Zhao Dan et al. The effect of radiotherapy on survival in newly‐diagnosed metastatic head and neck squamous cell carcinoma(HNSCC)[J]. Chinese Journal of Radiation Oncology, 2022, 31(8): 685-690.
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