Efficacy of Targeted Chemoradiation and Planned Selective Neck Dissection to Control Bulky Nodal Disease in Advanced Head and Neck Cancer

Robbins, K. Thomas; Wong, Frank S. H.; Kumar, Parvesh; Hartsell, William F.; Vieira, Francisco; Mullins, Brandon T.; Niell, Harvey B.

doi:10.1001/archotol.125.6.670

Cited by 95 publications

(57 citation statements)

References 19 publications

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“…17,18 We and others have, in the absence of clinically or radiographically evident disease, advocated close monitoring of the neck, even for those initially staged as N2 or N3. [19][20][21][22] The criteria for proceeding with neck dissection in the case of a partial clinical or radiographic response are not well-established. CT and MR imaging often yield equivocal findings based on size criteria, though some standards for radiographic evaluation of the neck are starting to emerge.…”

Section: Discussionmentioning

confidence: 99%

Sonographic Examination of the Neck after Definitive Radiotherapy for Node-Positive Oropharyngeal Cancer

Yom¹,

Garden²,

Staerkel³

et al. 2011

AJNR Am J Neuroradiol

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Section: Discussionmentioning

confidence: 99%

Sonographic Examination of the Neck after Definitive Radiotherapy for Node-Positive Oropharyngeal Cancer

Yom¹,

Garden²,

Staerkel³

et al. 2011

AJNR Am J Neuroradiol

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“…RADPLAT treatment appears to offer better locoregional control and survival than conventional nonsurgical treatment [36,43,44]. Consequently, variables previously reported to influence outcome may not be equally applicable to this new treatment modality.…”

Section: Predictors Of Successmentioning

confidence: 97%

“…Despite this, patients treated with RADPLAT have demonstrated good regional as well as local control rates [43,44]. Control of bulky (stage N2 or N3) nodal disease was recently exam- The Oncologist ® ined in a prospective analysis of 52 patients with HNSCC.…”

Section: Control Of Nodal Diseasementioning

confidence: 99%

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RADPLAT: An Alternative to Surgery?

2006

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Head and neck cancer frequently presents at a late stage, leading to a poor prognosis despite optimal treatment with surgery and/or radiotherapy. Chemotherapy for advanced disease has shown little benefit as a single-modality treatment, and the use of concurrent chemoradiation is limited by problems with severe toxicity at higher doses. RADPLAT is the acronym used to describe a new technique, combining intra-arterial delivery of cisplatin with systemic neutralization by i.v. sodium thiosulphate, and concurrent radiotherapy. This allows very high cisplatin dose intensities to be used while potentially minimizing adverse systemic effects. Initial results suggest that excellent locoregional control rates are achievable in patients with unresectable disease, with a favorable side-effect profile when compared with conventional chemoradiation protocols. In addition, RADPLAT may potentially be of benefit in selected patients with resectable disease, allowing for preservation of organ function and quality of life without compromising locoregional control or survival. While current phase II data are encouraging, phase III randomized controlled trials are required in order to directly compare RADPLAT with i.v. chemoradiation therapy, the current standard of care. This article reviews the evolution of the RADPLAT concept, from initial clinical trials to its current application in the treatment of patients with advanced head and neck cancer.

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“…Several studies have evaluated the response rate and survival of patients using this technique. 62,[64][65][66] Although this form of therapy has been studied for many years, the results have been variable, with heterogeneous use of this technique depending on institution or practitioner preference. However, several trials, particularly those using cisplatin-based regimens, indicate that a high response rate can be achieved.…”

mentioning

confidence: 99%

Interventional Neuroradiology of the Head and Neck

Gandhi

Gemmete

Ansari

et al. 2008

AJNR Am J Neuroradiol

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SUMMARY:Interventional neuroradiology procedures are a valuable asset in the diagnosis, treatment, and surgical management of various disorders affecting the extracranial head and neck. A detailed understanding of cross-sectional and vascular anatomy and an awareness of potential collateral pathways between extracranial and intracranial vessels are essential for ensuring safe and successful procedures. With the use of high-quality imaging and a meticulous technique, the incidence of major complications is extremely low.

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Efficacy of Targeted Chemoradiation and Planned Selective Neck Dissection to Control Bulky Nodal Disease in Advanced Head and Neck Cancer

Abstract: Selective neck dissection appears to be an effective adjunct to targeted chemoradiation in controlling N2 to N3 neck disease.

Cited by 95 publications

References 19 publications

Sonographic Examination of the Neck after Definitive Radiotherapy for Node-Positive Oropharyngeal Cancer

Sonographic Examination of the Neck after Definitive Radiotherapy for Node-Positive Oropharyngeal Cancer

RADPLAT: An Alternative to Surgery?

Interventional Neuroradiology of the Head and Neck

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