Impact of neck node radioresponsiveness on the regional control probability in patients with oropharynx and pharyngolarynx cancers managed by definitive radiotherapy

Radiotherapeutic management of bulky cervical lymphadenopathy in squamous cell carcinoma of the head and neck:Is Postradiotherapy Neck Dissection Necessary?

“…This result is very similar to the 5% neck relapse rate which we observed in near complete neck responders. It was also observed that the risk of neck relapse was unrelated to lymph node size for complete responders, further supporting the conclusions made in the reports from the Institut Curie [8] noted above. Although the break point is 3 cm, this lack of correlation of neck failure by lymph node size ( Fig.…”

“…This observation is similar to the 93% neck control rate observed in our complete responders. In a later report [8], a more detailed correlative analysis studied the influence of lymph node size and tumor clearance. For complete neck responders by 6-month follow-up (with the primary site controlled), neck control rate was 95% for nodes <6 cm.…”

“…Some clinical data has demonstrated that the management of such cases may be individualized on the basis of carefully monitored tumor regression rates. One such experience has demonstrated that recurrence rates after radiotherapy were very low when tumor at the primary site or in the neck had completely regressed within 3 months after completion of treatment [8,9]. Another more recent series, using a concomitant boost twice-daily accelerated hyperfractionated schedule, has also examined the outcomes in patients who were observed after complete neck responses with radiotherapy alone and found excellent neck control rates [10,11].…”

Metastatic Lymph-node Clearance from Head and Neck Epidermoid Carcinomas Following Radiotherapy

“…Tumor clearance patterns similar to those presented in our present study were observed by Bataini et al (8), who used metastatic LNs from the oropharyngeal and hypopharyngeal squamous cell carcinomas. They observed that in LNs, 50% of which achieved a complete response, those measuring less than 3 cm in diameter regressed 1.5 (CR) in terms of the capacity for biological clearance, as DD expressed as a percentage of the pre-RT LN volume (day − 1 ).…”

Markers of neck failure in oral cavity and oropharyngeal carcinomas treated with radiotherapy

“…4 Using the response to radiotherapy as a predicting factor is misleading because if only one third of the nodes (247 of 759) completely regressed at the end of the treatment, at 6 months only 10% of the nodes remained palpable. 18 Our current policy is to perform salvage neck dissection for all N stage cases in which residual disease is still present 1 month after radiotherapy or radiochemotherapy.…”