Browse > Article
http://dx.doi.org/10.3857/jkstro.2010.28.1.9

Significance of the Failure Patterns in Cervical Lymph Nodes Achieving a Complete Response to Radical Radiotherapy  

Nam, Ji-Ho (Department of Radiation Oncology, Pusan National University School of Medicine)
Kim, Won-Taek (Department of Radiation Oncology, Pusan National University School of Medicine)
Ki, Yong-Kan (Department of Radiation Oncology, Pusan National University School of Medicine)
Kim, Dong-Hyun (Department of Radiation Oncology, Pusan National University School of Medicine)
Choi, Young-Jin (Department of Internal Medicine, Pusan National University School of Medicine)
Cho, Kyu-Sup (Department of Otolaryngology, Pusan National University School of Medicine)
Lee, Jin-Choon (Department of Otolaryngology, Pusan National University School of Medicine)
Lee, Byung-Joo (Department of Otolaryngology, Pusan National University School of Medicine)
Kim, Dong-Won (Department of Radiation Oncology, Pusan National University School of Medicine)
Publication Information
Radiation Oncology Journal / v.28, no.1, 2010 , pp. 9-15 More about this Journal
Abstract
Purpose: This study was performed to examine the neck failure patterns after a complete response (CR) to definitive radiotherapy for advanced head and neck cancer patients, as well as evaluate the clinical significance of the results of this study. Materials and Methods: Between 1987 and 2008, the clinical data of patients who had been treated with radical radiotherapy for primary squamous cell carcinomas and enlarged cervical lymph nodes was analyzed retrospectively. Ultimately, the cases that showed CR of the cervical lymph node lesions to full-dose radiotherapy were included in this study. The recurrent rate and sites in the cervical lymphatic area were evaluated periodically by radiologic imaging studies, along with some factors which might have affected the rate of recurrence. Results: A total of 73 patients who achieved CR in neck area after radiotherapy were included in this study. The rate of subsequent neck failure among those patients was 19.2%. There was only a 5.5% failure rate in the 55 patients who underwent radiotherapy in their primary site. Eighty percent of the recurrent cases were found within 3 years (median follow-up, 68 months). The majority of neck recurrent cases (47%) were accompanied with the failure of the primary lesions. The initial response of the primary site and the method of radiotherapy simulation were significant prognostic factors associated with the nodal recurrence rate. Conclusion: The recurrence rate of cervical nodes in patients with CR to radiotherapy in the primary site and neck area was about 5%. These patients could be followed up with close observation without a planned neck dissection.
Keywords
Neck failure; Complete response; Radiotherapy; Head and neck carcinoma;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Mendenhall WM, Million RR, Cassisi NJ. Squamous cell carcinoma of the head and neck treated with radiation therapy: the role of neck dissection for clinically positive neck nodes. Int J Radiat Oncol Biol Phys 1986;12:733-740   DOI   ScienceOn
2 Stenson KM, Huo D, Blair E, et al. Planned postchemoradiation neck dissection: significance of radiation dose. Laryngoscope 2006;116:33-36   DOI   ScienceOn
3 Yeung AR, Liauw SL, Amdur RJ, et al. Lymph nodepositive head and neck cancer treated with definitive radiotherapy: can treatment response determine the extent of neck dissection? Cancer 2008;112:1076-1082   DOI   ScienceOn
4 Greven KM, Williams DW 3rd, Browne JD, et al. Radiographic complete response on post treatment CT imaging eliminates the need for adjuvant neck dissection after treatment for node positive head and neck cancer. Am J Clin Oncol 2008;31:169-172   DOI   ScienceOn
5 Yao M, Hoffman HT, Chang K, et al. Is planned neck dissection necessary for head and neck cancer after intensitymodulated radiotherapy? Int J Radiat Oncol Biol Phys 2007;68:707-713   DOI   ScienceOn
6 Yao M, Smith RB, Graham MM, et al. The role of FDG PET in management of neck metastasis from head-and-neck cancer after definitive radiation treatment. Int J Radiat Oncol Biol Phys 2005;63:991-999   DOI   ScienceOn
7 Brkovich VS, Miller FR, Karnad AB, et al. The role of positron emission tomography scans in the management of the N-positive neck in head and neck squamous cell carcinoma after chemoradiotherapy. Laryngoscope 2006;116:855-858
8 Rogers JW, Greven KM, McGuirt WF, et al. Can post- RT neck dissection be omitted for patients with head-andneck cancer who have a negative PET scan after definitive radiation therapy? Int J Radiat Oncol Biol Phys 2004;58:694-697   DOI   ScienceOn
9 Inoue H, Nibu K, Saito M, et al. Quality of life after neck dissection. Arch Otolaryngol Head Neck Surg 2006;132:662-666   DOI   ScienceOn
10 Peters LJ, Weber RS, Morrison WH, et al. Neck surgery in patients with primary oropharyngeal cancer treated by radiotherapy. Head Neck 1996;18:552-559   DOI   ScienceOn
11 Rengan R, Pfister DG, Lee NY, et al. Long-term neck control rates after complete response to chemoradiation in patients with advanced head and neck cancer. Am J Clin Oncol 2008;31:465-469   DOI   ScienceOn
12 Yang DS, Choi MS, Choi JO. Nodal status of the head and neck cancer patients. J Korean Soc Ther Radiol 1997;15:321-330
13 Liauw SL, Mancuso AA, Amdur RJ, et al. Postradiotherapy neck dissection for lymph node-positive head and neck cancer: the use of computed tomography to manage the neck. J Clin Oncol 2006;24:1421-1427   DOI   ScienceOn
14 Pletcher SD, Kaplan MJ, Eisele DW, et al. Management of cervical metastases in advanced squamous cell carcinoma of the base of tongue. Arch Otolaryngol Head Neck Surg 2003;129:983-986   DOI   ScienceOn
15 Vikram B, Strong EW, Shah JP, Spiro R. Failure in the neck following multimodality treatment for advanced head and neck cancer. Head Neck Surg 1984;6:724-729   DOI   ScienceOn
16 Mantravadi RV, Skolnik EM, Haas RE, Applebaum EL. Patterns of cancer recurrence in the postoperatively irradiated neck. Arch Otolaryngol 1983;109:753-756   DOI
17 Johnson CR, Silverman LN, Clay LB, Schmidt-Ullrich R. Radiotherapeutic management of bulky cervical lymphadenopathy in squamous cell carcinoma of the head and neck: is postradiotherapy neck dissection necessary? Radiat Oncol Investig 1998;6:52-57   DOI   ScienceOn
18 Mendenhall WM, Villaret DB, Amdur RJ, Hinerman RW, Mancuso AA. Planned neck dissection after definitive radiotherapy for squamous cell carcinoma of the head and neck. Head Neck 2002;24:1012-1018   DOI   ScienceOn
19 Fletcher GH, Shukovsky LJ. The interplay of radiocurability and tolerance in the irradiation of human cancers. J Radiol Electrol Med Nucl 1975;56:383-400