Episode 49 | 2026/05/25

ENT Update Podcast EP52 - 頭頸外科與腫瘤學（2026/05/25） 本集論文： 1⃣️ Near-infrared fluorescence imaging-guided surgery using cRGD-ZW800 to improve surgical resection margins in oral cancer: a phase I/II feasibility trial PMID: 42173866 https://pubmed.ncbi.nlm.nih.gov/42173866/ DOI: 10.1038/s41467-026-73554-7 關鍵發現：Phase I/II trial (n=24) 顯示 cRGD-ZW800 螢光導引可即時改變口腔癌手術邊緣決策，四例病人中偵測到肉眼無法辨識的腫瘤殘留 2⃣️ De-Escalated Adjuvant Radiation Therapy in Patients With HPV-Positive Oropharyngeal Cancer PMID: 42149594 https://pubmed.ncbi.nlm.nih.gov/42149594/ DOI: 10.1001/jamanetworkopen.2026.12837 關鍵發現：NCDB 資料庫 3300+ 病人，降階放療組兩年局部控制率 93%，急性三度黏膜炎從 42% 降至 18% 3⃣️ Dissociating recurrence risk from mortality: a 10 year analysis challenging the independent prognostic value of depth of invasion in oral cavity squamous cell carcinoma PMID: 42107224 https://pubmed.ncbi.nlm.nih.gov/42107224/ DOI: 10.1016/j.oraloncology.2026.108001 關鍵發現：多變項分析中 DOI 獨立預後價值大幅衰減（HR 2.1→1.3），不應單獨用於治療決策 4⃣️ Transoral Robotic Surgery-Based Treatment Versus Definitive Chemoradiation for Oropharyngeal Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis PMID: 42087273 https://pubmed.ncbi.nlm.nih.gov/42087273/ DOI: 10.1002/hed.70308 關鍵發現：TORS 組五年存活率 88% vs 放化療 85%（無顯著差異），但吞嚥功能與口乾發生率顯著較優 5⃣️ The submental artery pedicled flap for peri-auricular and parotid reconstruction: a comparative cohort PMID: 42176358 https://pubmed.ncbi.nlm.nih.gov/42176358/ DOI: 10.1016/j.oraloncology.2026.108032 關鍵發現：頦下動脈皮瓣 vs 顳肌皮瓣，美觀滿意度更高、手術時間縮短 40 分鐘、住院天數更短，皮瓣存活率 100% 6⃣️ Osteoradionecrosis After Modern Radiotherapy for Oral Cavity Cancer: Incidence and Risk Factors PMID: 42111429 https://pubmed.ncbi.nlm.nih.gov/42111429/ DOI: 10.1002/lio2.70431 關鍵發現：IMRT/VMAT 時代五年 ORN 累積發生率 7.2%，重度 ORN 2.8%；關鍵風險因子：下齒齦原發腫瘤、V6025%、放療前拔牙