Analysis Of Short-term Efficacy And Safety Of Intraoperative Radiotherapy For Head And Neck Malignancies

Objectives:In this study,we initially explore the recent efficacy and safety of this technique by developing a technique for head and neck malignancy surgery combined with intraoperative radiotherapy.To explore new adjuvant treatment methods for improving patient survival quality,and to provide new treatment ideas for comprehensive treatment options for head and neck malignancies.Methods:In this study,42 patients with head and neck malignancies who visited the first Department of head and neck surgery at Yunnan Cancer Hospital between December 2020 and December 2022 were selected for retrospective analysis,of whom 15 patients were treated with radical surgery combined with intraoperative radiotherapy(IORT group)and 27 patients were treated with radical surgery combined with extracorporeal radiotherapy(EBRT group).The IORT group included8 patients with laryngeal malignancies and 7 patients with parotid malignancies.The EBRT group included 15 patients with laryngeal malignancies and 12 patients with parotid malignancies.All patients in the IORT group were treated with an intrabeam surgical stereotactic Mini accelerated intraoperative radiotherapy system,the irradiation tools were all spherical applicators,and the dose of intraoperative radiotherapy for patients in the IORT group was between 8 and 12 Gy;All patients in the EBRT group underwent radical surgical resection of tumor lesions combined with extracorporeal radiation therapy.All intraoperative and postoperative indicators including general clinical data,duration of surgery,duration of postoperative hospital stay,perioperative mortality,complication rate,postoperative pain scores of patients in each group were analyzed retrospectively,and the patients were followed for days receiving complete treatment,postoperative quality of life,progression free survival(DFS),locoregional control rate(LRC),distant metastasis rate Survival follow up data of overall survival(OS)to evaluate the patients’ short-term postoperative recurrence rate and functional status of quality of life and health,spss24.0 software was used for data statistical analysis.It was used to initially explore the short-term efficacy and safety of intraoperative radiotherapy in the comprehensive treatment of head and neck malignancies.Results:1.There was no significant difference between the IORT and EBRT groups in terms of age,gender,pathological type,tumor size,smoking history,drinking history and family history(P > 0.05).2.The median time of surgery was 5.6(4.5,7.1)h in the IORT group and 4.5(3.2,5.1)h in the EBRT group,and the median time of surgery was longer in the IORT group than in the EBRT group,with a statistically significant difference between the two groups(P < 0.05);There were no significant differences in the number of postoperative hospital days or pain scores at 24 h after surgery between the two groups(P > 0.05).3.There was significant difference in postoperative infection between IORT group and EBRT group(P < 0.05).There was no significant difference in postoperative wound healing,bleeding,fever,dry mouth after radiotherapy,taste loss,radiation stomatitis and radiation dermatitis between IORT group and EBRT group(P > 0.05).4.Patients in the IORT group received complete treatment for a mean of 36.22 d and patients in the EBRT group received complete treatment for a mean of 76.25 d,with a statistically significant difference between the two groups(P < 0.001).5.The mean KPS score of the IORT group patients was 70.39 points before surgery and that of the EBRT group patients was 69.87 points before surgery,with no significant difference between the two groups(P > 0.05);Patients in the IORT group had a mean KPS score of 83.05 at 1 month after completing treatment,and patients in the EBRT group had a mean KPS score of 76.41 at 1 month after completing treatment,with a statistically significant difference between the two groups(P < 0.05).6.The median DFS of patients in the IORT group was 12 months and that of patients in the EBRT group was 11 months,with no significant difference between the two groups(P > 0.05;The local recurrence rate was 13.3% in the IORT group and3.7% in the EBRT group patients,with no significant difference between the two groups(P > 0.05);The distant metastasis rate was 6.7% for the IORT group patients and 7.4% for the EBRT group patients,with no significant difference between the two groups(P > 0.05);At the end of follow-up,the overall survival(OS)rate at 2 years was 93.3% for the IORT group patients and 92.6% for the EBRT group patients,with no significant difference between the two groups(P > 0.05).Conclusions: 1.Radical surgery combined with intraoperative radiotherapy for head and neck malignant tumors prolonged the operation time;However,it did not extend the postoperative hospitalization days of patients;Nor did it increase the incidence of postoperative complications;There is no obvious effect on the postoperative recovery of patients;And the total treatment days of patients are shortened.2.Surgery combined with IORT for head and neck cancer had no significant effect on the short-term outcome.3.Surgery combined with IORT is expected to be a new adjuvant therapy with good safety for patients with head and neck malignant tumors,but the long-term efficacy of patients needs to be extended for further confirmation.