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Persistent neck disease after chemoradiation for head and neck squamous cell carcinoma

Published online by Cambridge University Press:  19 September 2012

J G Sanders ,
K G Smith ,
M B Jameson ,
C de Groot  and
J White
J G Sanders*
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Wellington Hospital, Hamilton, New Zealand
K G Smith
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Auckland City Hospital, Hamilton, New Zealand
M B Jameson
Affiliation:
Department of Oncology, Waikato Hospital, Hamilton, New Zealand
C de Groot
Affiliation:
Department of Oncology, Waikato Hospital, Hamilton, New Zealand
J White
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Waikato Hospital, Hamilton, New Zealand
*
Address for correspondence: Dr James G Sanders, ORL Registrar, Wellington City Hospital, Private Bag 7902, Wellington South, Wellington, New Zealand E-mail: [email protected]
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Abstract

Objective:

This study aimed to identify the incidence of residual viable neck disease in patients with mucosal squamous cell carcinoma of the upper aero-digestive tract, following primary chemoradiation at a tertiary centre.

Study design:

Retrospective review.

Methods:

Retrospective chart review of patients treated with primary chemoradiation for squamous cell carcinoma of the aero-digestive tract between August 2001 and August 2008. Neck status pre- and post-treatment was the primary focus.

Results:

Forty-two patients with node-positive disease prior to chemoradiation were included. Thirty-seven (88.1 per cent) achieved complete response to treatment: no patient in this group underwent neck dissection, five died due to recurrence at the primary site or distant metastasis, and none suffered neck recurrence. Five (11.9 per cent) patients achieved partial response to chemoradiation and underwent neck dissection; viable tumour was found in one patient.

Conclusion:

Our data support conservative management of the neck in patients with complete response to chemoradiation, and consolidation neck dissection in patients with partial response.

Keywords

Squamous Cell CarcinomaChemotherapyRadiotherapyNeoplasm MetastasisRadiology
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 126 , Issue 11 , November 2012 , pp. 1121 - 1126
Copyright
Copyright © JLO (1984) Limited 2012

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References

1 Hillel, AT, Fakhry, C, Pai, SI, Williams, MF, Blanco, RG, Zinreich, ES et al. Selective versus comprehensive neck dissection after chemoradiation for advanced oropharyngeal squamous cell carcinoma. Otolaryngol Head Neck Surg 2009;141:737–42CrossRefGoogle ScholarPubMed
2 Pellitteri, PK, Ferlito, A, Rinaldo, A, Shah, JP, Weber, RS, Lowry, J et al. Planned neck dissection following chemoradiotherapy for advanced head and neck cancer: is it necessary at all? Head Neck 2006;28:166–75Google Scholar
3 Yovino, S, Settle, K, Taylor, R, Wolf, J, Kwok, Y, Cullen, K et al. Patterns of failure among patients with squamous cell carcinoma of the head and neck who obtain a complete response to chemotherapy. Head Neck 2010;32:46–52 Google Scholar
4 McHam, SA, Adelstein, DJ, Rybicki, LA, Lavertu, P, Esclamado, RM, Wood, BG et al. Who merits a neck dissection after definitive chemoradiotherapy for N2-N3 squamous cell head and neck cancer? Head Neck 2003;25:791–8CrossRefGoogle Scholar
5 Lango, MN, Myers, JN, Garden, AS. Controversies in surgical management of the node-positive neck after chemoradiation. Semin Radiat Oncol 2009;19:24–8Google Scholar
6 Porceddu, SV, Jarmolowski, E, Hicks, RJ, Ware, R, Weih, L, Rischin, D et al. Utility of positron emission tomography for the detection of disease in residual neck nodes after (chemo)radiotherapy in head and neck cancer. Head Neck 2005;27:175–81CrossRefGoogle ScholarPubMed
7 Corry, J, Peters, L, Fisher, R, Macann, A, Jackson, M, McClure, B et al. N2-N3 Neck nodal control without planned neck dissection for clinical/radiologic complete responders – results of trans Tasman radiation oncology group study. Head Neck 2008;30:737–42Google Scholar
8 Henle, W, Henle, G, Ho, HC, Burtin, P, Cachin, Y, Clifford, P et al. Antibodies to Epstein-Barr virus in nasopharyngeal carcinoma, other head and neck neoplasms and control groups. J Natl Cancer Inst 1970;44:225–32Google Scholar
9 Wolf, H, zur Hausen, H, Becker, V. EB viral genomes in epithelial nasopharyngeal carcinoma cells. Nat New Biol 1973;244:245–7CrossRefGoogle ScholarPubMed
10 Young, LS, Clark, D, Sixby, JW, Richinson, AB. Epstein-Barr virus receptors on human pharyngeal epithelium. Lancet 1986;i:240–2CrossRefGoogle Scholar
11 Niedobitek, G. Epstein-Barr virus infection in the pathogenesis of nasopharyngeal carcinoma. Mol Pathol 2000;53:248–54CrossRefGoogle ScholarPubMed
12 Lavertu, P, Adelstein, DJ, Saxton, JP, Secic, M, Wanamaker, JR, Eliachar, I et al. Management of the neck in a randomised trial comparing concurrent chemotherapy and radiotherapy with radiotherapy alone in resectable stage III and IV squamous cell head and neck cancer. Head Neck 1997;19:559–66Google Scholar
13 Brizel, DM, Prosnitz, RG, Hunter, S, Fisher, SR, Clough, RL, Downey, MA et al. Necessity for adjuvant neck dissection in setting of concurrent chemoradiation for advanced head-and-neck cancer. Int J Radiat Oncol Biol Phys 2004;58:1418–23CrossRefGoogle ScholarPubMed
14 Armstrong, J, Pfister, D, Strong, E, Heimann, R, Kraus, D, Polishook, A et al. The management of the clinically positive neck as part of a larynx preservation approach. Int J Radiat Oncol Biol Phys 1993;26:759–65CrossRefGoogle ScholarPubMed
15 Lau, H, Phan, T, Mackinnon, J, Matthews, TW. Absence of planned neck dissection for the N2-N3 neck after chemoradiation for locally advanced squamous cell carcinoma of the head and neck. Arch Otolaryngol Head Neck Surg 2008;134:257–61Google Scholar
16 Dammann, F, Horger, M, Mueller-Berg, M, Schlemmer, H, Claussen, CD, Hoffman, J et al. Rational diagnosis of squamous cell carcinoma of the head and neck region: comparative evaluation of CT, MRI, and 18FDG PET. AJR Am J Roentgenol 2005;184:1326–31Google Scholar
17 Sakai, O, Curtin, HD, Romo, LV, Som, PM. Lymph node pathology. Benign proliferative, lymphoma, and metastatic disease. Radiol Clin North Am 2000;Sep;38:979–98Google Scholar
18 Eisenhauer, EA, Therasse, P, Bogaerts, J, Schwartz, LH, Sargent, D, Ford, R et al. New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer 2009;45:228–47Google Scholar
19 Yeung, AR, Liauw, SL, Amdur, RJ, Mancuso, AA, Hinerman, RW, Morris, CG et al. Lymph node-positive head and neck cancer treated with definitive radiotherapy: can treatment response determine the extent of neck dissection? Cancer 2008;112:1076–82Google Scholar
20 Kubota, K, Yokoyama, J, Yamaguchi, K, Ono, S, Qureshy, A, Itoh, M et al. FDG-PET delayed imaging for the detection of head and neck cancer recurrence after radio-chemotherapy: comparison with MRI/CT. Eur J Nucl Med Mol Imaging 2004;31:590–5Google Scholar
21 Gupta, T, Master, Z, Kannan, S, Agarwal, JP, Ghsoh-Laskar, S, Rangarajan, V et al. Diagnostic performance of post-treatment FDG PET or FDG PET/CT imaging in head and neck cancer: a systematic review and meta-analysis. Eur J Nucl Med Mol Imaging 2011;38:2083–95CrossRefGoogle ScholarPubMed
22 Yao, M, Graham, MM, Hoffman, HT, Smith, RB, Funk, GF, Graham, SM et al. The role of post-radiation therapy FDG PET in prediction of necessity for post-radiation therapy neck dissection in locally advanced head-and-neck squamous cell carcinoma. Int J Radiat Oncol Biol Phys 2004;59:1001–10Google Scholar