Recurrence of Lymph Node Micrometastases After Radiotherapy for Head and Neck Carcinoma: A Propensity Score-matched Study

2021 ◽  
Vol 1 (3) ◽  
pp. 165-172
Author(s):  
YU SUZUKI ◽  
KEIICHI JINGU ◽  
EIICHI ISHIDA ◽  
TAKAKI MURATA ◽  
MASAKI KUBOZONO
Keyword(s):  
Lymph Node ◽  
Propensity Score ◽  
Head And Neck ◽  
Irradiation Dose ◽  
Concurrent Chemoradiotherapy ◽  
Head And Neck Carcinoma ◽  
Lymph Node Micrometastases ◽  
Neck Carcinoma ◽  
Matched Study ◽  
Observation Period

Background: The standard irradiation dose to the elective lymph node area (ELNA) in locally patients with advanced head and neck squamous cell carcinoma (LA-HNSCC) to control lymph node micrometastases (LN-MM) has not changed since it was empirically determined in the 1950s. We investigated the optimal irradiation dose for controlling LN-MM in ELNAs. Patients and Methods: The pattern of recurrence of LA-HNSCC was retrospectively evaluated in patients who underwent concurrent chemoradiotherapy with cisplatin or radiation therapy alone. Results: In total, 162 patients were enrolled. The median observation period was 34 months. No recurrence was found in ELNAs. After propensity score matching, a cisplatin dose of ≥200 mg/m2 yielded a significantly higher overall survival rate (p≤0.001) and locoregional control rate (p=0.034) than did a dose of <100 mg/m2. Conclusion: CCRT with a cisplatin dose of ≥200 mg/m2 can reduce the irradiation dose to 40-44 Gy at 2 Gy per fraction to control LN-MM.

Concurrent chemoradiotherapy with low‐dose weekly platinum agent for head and neck carcinoma

2020 ◽  
Vol 45 (6) ◽  
pp. 952-955 ◽  
Author(s):  
Masayuki Kitano ◽  
Tsuyoshi Kojima ◽  
Yusuke Okanoue ◽  
Shintaro Fujimura ◽  
Seiji Oyagi ◽  
...  
Keyword(s):  
Head And Neck ◽  
Low Dose ◽  
Concurrent Chemoradiotherapy ◽  
Head And Neck Carcinoma ◽  
Neck Carcinoma ◽  
Platinum Agent

Stereotactic radiosurgery for patients with recurrent head and neck carcinoma: Five years’ observation report.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e16049-e16049
Author(s):  
Koji Kawaguchi
Keyword(s):  
Lymph Node ◽  
Head And Neck ◽  
Stereotactic Radiosurgery ◽  
Lymph Node Metastases ◽  
Head And Neck Carcinoma ◽  
Complete Response ◽  
Lymph Node Involvement ◽  
Neck Carcinoma ◽  
Node Metastases ◽  
Recurrent Head

e16049 Background: The aim of this study is to examine the effect of stereotactic radiosurgery (SRS) in the treatment of advanced, recurrent lesions for head and neck carcinoma both with and without lymph node involvement. Methods: Between April 2006 and July 2007, 22 patients (mean age 67 years) with advanced, recurrent head and neck carcinoma were treated with SRS by CyberKnife-II. All of the patients excepted one had biopsy confirmed disease prior to SRS. Patients included 3 rT2, 8 rT3, and 9 rT4; 8 of the patients had lymph node metastases. Marginal SRS doses were 20-42 Gy delivered in two to five fractions. Starting one month after SRS, all patients received S-1 oral chemotherapy for one year. Results: At an overall median follow-up of 64 months (range, 4-69 months), for the 14 locally recurrent patients without lymph node metastases, 9 patients (64.3%) had a complete response (CR), 1 patient (7.1%) had a partial response (PR), 1 patient (7.1%) had stable disease (SD), and 3 patients (21.4%) had progressive disease (PD). For the 8 patients with lymph node metastases, 1 patient with a single retropharyngeal (12.5%) had CR; the remaining 7 patients (87.5%) all progressed. Nine patients have died from their cancer. The overall 5-year survival for the patients with and without lymph node metastases was 12.5% and 78.6%, respectively. Conclusions: These results show the benefit of stereotactic radiosurgery salvage treatment for advanced, recurrent lesions, without lymph node metastases in previously irradiated head and neck cancer.

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