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Tongue squamous cell carcinoma (TSCC) is one of the most prevalent types of head and neck malignancies, and its treatment typically involves surgery combined with radiotherapy and chemotherapy. Despite advancements in treatment, TSCC recurrence remains a significant concern, affecting approximately 20% of treated patients. This study aims to assess the impact of the time interval between radiotherapy and surgery on oncological outcomes in TSCC patients. A total of 215 patient records (98 females and 117 males) with biopsy-proven TSCC receiving various treatments were extracted. The Inclusion criteria were patients who received external beam radiotherapy, had no detectable metastasis, underwent oncological surgery, and received a minimum radiation dose of 60 Gy. Ultimately, 108 patients met these criteria and were included in the analysis. The surgical procedure involved glossectomy, and the prescribed radiotherapy dose exceeded 60 Gy. Patients were stratified based on tumor stage (early-stage and locally advanced stage) and the timing of radiotherapy initiation after surgery (less than 47 days and more than 47 days). The study analyzed loco-regional control, loco-regional recurrence, disease-free survival, and overall survival as endpoints. These endpoints were compared between different subgroups based on tumor stage and surgery to radiotherapy interval. A retrospective analysis was conducted on the medical records of 108 patients who underwent surgical treatment followed by radiotherapy between 2011 and 2022. In early-stage patients, radiotherapy within 47 days after surgery demonstrated superior disease-free survival (DFS) outcomes. However, in locally advanced-stage patients, the opposite trend was observed, with a longer interval between surgery and radiotherapy associated with improved DFS outcomes. These patterns were similarly reflected in overall survival (OS) outcomes. Notably, the difference in loco-regional recurrence (LLR) outcomes was more pronounced among advanced-stage patients. In conclusion, this study highlights that advanced-stage TSCC patients tend to experience earlier recurrence, potentially necessitating additional surgical interventions or precluding the administration of radiotherapy, as investigated in our study. These findings shed light on the significance of the time interval between surgery and radiotherapy in TSCC management. [ABSTRACT FROM AUTHOR]

Background: It remains controversial whether adding ezetimibe to low/moderate-intensity statins has a more beneficial impact on the treatment efficacy and safety of patients with existing atherosclerotic cardiovascular disease (ASCVD) compared to high-intensity statin regimens., Hypothesis: A combination of low/moderate-intensity statins plus ezetimibe might be more effective and safer than high-intensity statin monotherapy., Methods: We searched databases for randomized controlled trials comparing lipid profile alterations, drug-related adverse events, and MACE components between high-intensity statin monotherapy and low/moderate-intensity statin plus ezetimibe combination therapy. Pooled risk ratios (RR), mean differences (MD), and 95% confidence intervals (95% CI) were estimated using a random-effects model., Results: Our comprehensive search resulted in 32 studies comprising 6162 patients treated with monotherapy against 5880 patients on combination therapy. Combination therapy was more effective in reducing low-density lipoprotein cholesterol (LDL-C) levels compared to monotherapy (MD = -6.6, 95% CI: -10.6 to -2.5); however, no significant differences were observed in other lipid parameters. Furthermore, the combination therapy group experienced a lower risk of myalgia (RR = 0.27, 95% CI: 0.13-0.57) and discontinuation due to adverse events (RR = 0.61, 95% CI: 0.51-0.74). The occurrence of MACE was similar between the two treatment groups., Conclusions: Adding ezetimibe to low/moderate-intensity statins resulted in a greater reduction in LDL-C levels, a lower rate of myalgia, and less drug discontinuation compared to high-intensity statin monotherapy in patients with existing cardiovascular disease. However, according to our meta-analysis, the observed reduction in LDL-C levels in the combination group did not correlate with a reduction in MACE compared to the high-intensity statin group., (© 2024 The Author(s). Clinical Cardiology published by Wiley Periodicals, LLC.)