Objective:To evaluate the impact of postoperative radiotherapy (PORT) on oncological outcomes in node-negative early-stage oral squamous cell carcinoma (OSCC) with perineural invasion (PNI).Methods: A systematic review and meta-analysis was conducted using the PubMed, EMBASE, and Scopus databases for the period from 2000 to 2024. Studies comparing PORT versus observation in pN0 early-stage OSCC with PNI were included. Oncological outcomes assessed included overall survival (OS), disease-free survival (DFS), and local control (LC). A random-effects model was used to calculate log odds ratios, and heterogeneity was assessed using tau2, chi2, and I2statistics.Results: Seven retrospective studies comprising 522 patients (281 PORT, 241 no-PORT) were included. The 3-year overall survival (OS) was 86.3% in the PORT group compared to 71.1% in the no-PORT group (logOR = −1.03,p= 0.0012), while the 5-year OS was 88.1% versus 77.3% (logOR = −0.97,p= 0.0061). Disease-free survival (DFS) also favored PORT, with 3-year DFS at 86.3% versus 58.1% (logOR = −1.19,p< 0.001) and 5-year DFS at 86.3% versus 55% (logOR = −0.78,p= 0.003). Local control (LC) was higher in the PORT group, with 3-year LC rates of 89% compared to 72.2% in the no-PORT group (logOR = −1.13,p= 0.025).Conclusions: PORT significantly improves OS, DFS, and LC in node-negative early-stage OSCC with PNI as the sole adverse feature.
目的：评估术后放疗（PORT）对伴有神经周围侵犯（PNI）的淋巴结阴性早期口腔鳞状细胞癌（OSCC）患者肿瘤学预后的影响。 方法：系统检索2000年至2024年间PubMed、EMBASE和Scopus数据库，对比较pN0期早期PNI阳性OSCC患者接受PORT与单纯观察的研究进行系统综述和荟萃分析。评估的肿瘤学结局包括总生存期（OS）、无病生存期（DFS）和局部控制率（LC）。采用随机效应模型计算对数比值比，并使用tau²、chi²和I²统计量评估异质性。 结果：共纳入7项回顾性研究，涉及522例患者（PORT组281例，非PORT组241例）。PORT组3年总生存率为86.3%，非PORT组为71.1%（对数比值比 = −1.03，p = 0.0012）；5年总生存率分别为88.1%和77.3%（对数比值比 = −0.97，p = 0.0061）。无病生存率同样显示PORT组更优：3年无病生存率分别为86.3%和58.1%（对数比值比 = −1.19，p < 0.001），5年无病生存率分别为86.3%和55%（对数比值比 = −0.78，p = 0.003）。PORT组局部控制率更高，3年局部控制率为89%，非PORT组为72.2%（对数比值比 = −1.13，p = 0.025）。 结论：对于以PNI为唯一不良特征的淋巴结阴性早期OSCC，术后放疗能显著改善患者的总生存率、无病生存率和局部控制率。
肿瘤(癌症)患者之家