头颈癌经口机器人手术后放疗整合：辅助治疗、降阶梯治疗、功能保留与生存结局的文献计量学与知识图谱分析

文献信息

中文摘要

背景： 经口机器人手术（TORS）在部分头颈癌的多模式治疗路径中日益受到重视，其中术后病理可能影响放疗（RT）、放化疗（CRT）、治疗降阶梯和功能保留。本研究刻画了TORS后放疗整合研究的发展、知识结构和主题演变。
方法： 从Web of Science核心合集、Scopus和PubMed检索2010年1月1日至2026年8月1日的出版物。经去重、排除缺乏下游分析所需预定义字段的记录以及人工主题筛选后，纳入215篇出版物。文献计量学和知识图谱分析评估了发表和引用趋势、贡献者与协作、共被引、书目耦合、关键词与主题演变，以及探索性logistic生命周期和潜在狄利克雷分配（LDA）模型。
结果： 215篇出版物分布于54种来源，年增长率为14.72%；60.0%发表于2020-2026年。国际合著占13.49%。美国是通讯作者所属国家之首，占96篇出版物（占全部文献的44.7%）。引用和共被引结构将基础性TORS研究与HPV相关预后及术后RT/CRT证据联系起来。关键词和主题分析显示TORS和口咽鳞状细胞癌持续突出，同时辅助治疗、HPV相关疾病、吞咽和功能结局的代表性不断增加。书目耦合和因子分析表明存在大量主题重叠，而非清晰分离的研究领域。探索性logistic模型拟合仅为中等（R² = 0.778），未能完全捕捉实际发表峰值，而五主题LDA解的bootstrap稳定性有限（0.3356）。
结论： 文献已从以手术操作为主的探究转向更关注风险适配的术后管理。当前研究日益整合治疗选择、RT剂量和靶区修改以及功能结局。需要采用标准化术后风险定义和长期肿瘤学及功能评估的前瞻性多中心研究，以确定治疗降阶梯的适当限度。

英文摘要

BACKGROUND: Transoral robotic surgery (TORS) is increasingly considered within multimodality treatment pathways for selected head and neck cancers, in which postoperative pathology may influence radiotherapy (RT), chemoradiotherapy (CRT), treatment de-intensification, and functional preservation. This study characterized the development, knowledge structure, and thematic evolution of research on RT integration after TORS.
METHODS: Publications from 1 January 2010 to 1 August 2026 were retrieved from the Web of Science Core Collection, Scopus, and PubMed. After deduplication, exclusion of records lacking predefined fields required for downstream analyses, and manual topical screening, 215 publications were included. Bibliometric and knowledge-mapping analyses assessed publication and citation trends, contributors and collaboration, co-citation, bibliographic coupling, keyword and thematic evolution, and exploratory logistic life-cycle and latent Dirichlet allocation (LDA) models.
RESULTS: The 215 publications were distributed across 54 sources, with an annual growth rate of 14.72%; 60.0% were published during 2020-2026. International co-authorship accounted for 13.49%. The United States was the leading corresponding-author country, accounting for 96 publications (44.7% of the total corpus). Citation and co-citation structures linked foundational TORS studies with evidence on HPV-associated prognosis and postoperative RT/CRT. Keyword and thematic analyses showed persistent prominence of TORS and oropharyngeal squamous cell carcinoma, alongside increasing representation of adjuvant treatment, HPV-associated disease, swallowing, and functional outcomes. Bibliographic coupling and factorial analysis indicated substantial thematic overlap rather than clearly separated research domains. Exploratory logistic modeling showed only moderate fit (R² = 0.778) and did not fully capture the empirical publication peak, while the five-topic LDA solution had limited bootstrap stability (0.3356).
CONCLUSION: The literature has shifted from predominantly procedure-centered investigation toward greater attention to risk-adapted postoperative management. Current research increasingly integrates treatment selection, RT dose and target-volume modification, and functional outcomes. Prospective multicenter studies with standardized postoperative risk definitions and long-term oncologic and functional assessment are needed to define the appropriate limits of treatment de-intensification.