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

Ohara, Kiyoshi; Tatsuzaki, Hideo; Kurosaki, Y; Fuji, Hiroshi; Myo-Min,; Itai, Yuji; Hara, Akira; Kusakari, Jun; Ogata, Takashi

doi:10.1080/028418699431708

Cited by 3 publications

(1 citation statement)

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“…The patient and treatment characteristics between the two groups were well-balanced, but there were marginally more patients with nasopharyngeal cancer in group B. Metastases from nasopharyngeal carcinoma are more likely to be controlled than those of other HNSCCs (21,22). Despite this, local control of lymph node metastases was better in group A.…”

Section: Discussionmentioning

confidence: 95%

Initial Experience of Intentional Internal High-Dose Policy Volumetric Modulated Arc Therapy of Neck Lymph Node Metastases ≥ 2 cm in Patients With Head and Neck Squamous Cell Carcinoma

et al. 2021

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Background and PurposeMost locoregional recurrences after definitive radiotherapy for head and neck squamous cell carcinoma (HNSCC) develop “in-field.” Dose escalation while sparing organs at risk can be a good solution for improving local control without increasing adverse effects. This study investigated the safety and effectiveness of volumetric modulated arc therapy (VMAT) using intentionally internal high-dose policy (IIHDP) to treat neck lymph node metastases (NLNM) ≥ 2 cm in HNSCC patients.Materials and MethodsWe analyzed 71 NLNM from 51 HNSCC patients who had received definitive radiotherapy to treat NLNM ≥ 2 cm using the VMAT technique in our institution between February 2017 and August 2019. Thirty-seven NLNM from 25 patients were treated using IIHDP VMAT (group A), and 34 NLNM from 27 patients were treated with homogeneous-dose distribution policy (HDDP) VMAT (group B). One patient with three NLNM had one lymph node assigned to group A and the other two to group B. Adverse events and local recurrence-free survival (LRFS) was compared between the two groups.ResultsIn the median follow-up period of 527 days, there were no significant differences between the groups in terms of dermatitis or mucositis ≥ grade 2/3, but LRFS was significantly longer in group A (p = 0.007). In the Cox regression analysis after adjustment for the propensity score, group A also showed an apparently superior LFRS.ConclusionOur initial experience of IIHDP VMAT suggested that IIHDP VMAT to treat HNSCC neck lymph node metastases measuring ≥ 2 cm was feasible and possibly led to better local control than HDDP VMAT.

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Section: Discussionmentioning

confidence: 95%