Ipsilateral neck radiotherapy in N2b well-lateralized tonsil cancer - Approach with caution.
Adult
Aged
Aged, 80 and over
Antineoplastic Combined Chemotherapy Protocols
/ therapeutic use
Carcinoma, Squamous Cell
/ pathology
Chemoradiotherapy
Cisplatin
/ administration & dosage
Female
Fluorouracil
/ administration & dosage
Human papillomavirus 16
/ isolation & purification
Humans
Male
Middle Aged
Neoplasm Recurrence, Local
/ pathology
Radiotherapy, Intensity-Modulated
/ methods
Retrospective Studies
Tonsillar Neoplasms
/ pathology
elective nodal irradiation
head and neck cancer
oropharyngeal cancer
radiotherapy
unilateral neck radiotherapy
Journal
Head & neck
ISSN: 1097-0347
Titre abrégé: Head Neck
Pays: United States
ID NLM: 8902541
Informations de publication
Date de publication:
09 2019
09 2019
Historique:
received:
21
09
2018
revised:
26
03
2019
accepted:
02
04
2019
pubmed:
7
5
2019
medline:
4
11
2020
entrez:
7
5
2019
Statut:
ppublish
Résumé
Treatment of the uninvolved neck in well-lateralized tonsillar squamous cell carcinoma is controversial. We became concerned after a number of contralateral neck recurrences (CNRs) in patients receiving ipsilateral radiotherapy (RT). This is a single center retrospective series including patients with well-lateralized tonsillar cancer treated with ipsilateral neck RT between 2004 and 2011. We identified 53 patients treated with ipsilateral neck RT during the study period. The rate of CNR was 7.5% (4 of 53). All four patients had p16-positive, T1, N2b, M0 tumors. The subgroup of patients with N2b disease (28 of 53) had a CNR of 14.3%. We subsequently switched to treat patients with N2b with bilateral neck RT. We analyzed the outcomes of 23 patients with N2b treated with bilateral neck intensity-modulated RT (IMRT) and observed no CNRs. We observed a higher than expected rate of CNR in the N2b population. Bilateral neck IMRT for these patients represents a safe alternative.
Sections du résumé
BACKGROUND
Treatment of the uninvolved neck in well-lateralized tonsillar squamous cell carcinoma is controversial. We became concerned after a number of contralateral neck recurrences (CNRs) in patients receiving ipsilateral radiotherapy (RT).
METHODS
This is a single center retrospective series including patients with well-lateralized tonsillar cancer treated with ipsilateral neck RT between 2004 and 2011.
RESULTS
We identified 53 patients treated with ipsilateral neck RT during the study period. The rate of CNR was 7.5% (4 of 53). All four patients had p16-positive, T1, N2b, M0 tumors. The subgroup of patients with N2b disease (28 of 53) had a CNR of 14.3%. We subsequently switched to treat patients with N2b with bilateral neck RT. We analyzed the outcomes of 23 patients with N2b treated with bilateral neck intensity-modulated RT (IMRT) and observed no CNRs.
CONCLUSIONS
We observed a higher than expected rate of CNR in the N2b population. Bilateral neck IMRT for these patients represents a safe alternative.
Substances chimiques
Cisplatin
Q20Q21Q62J
Fluorouracil
U3P01618RT
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2937-2946Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2019 Wiley Periodicals, Inc.