Lin Doris, Glastonbury Christine M, Rafaelian Olga, Eisele David W, Wang Steven J
Department of Otolaryngology-Head and Neck Surgery, UCSF Comprehensive Cancer Center, San Francisco, CA, USA.
J Otolaryngol. 2007 Dec;36(6):350-6.
The purpose of this study was to determine the role of magnetic resonance imaging (MRI) to predict persistent nodal disease in head and neck cancer treated with chemoradiation.
Retrospective chart review of 38 patients with head and neck cancer and N2/N3 neck disease who were treated with chemoradiation and who had an MRI 6 to 8 weeks following treatment.
Sixteen patients had MRI findings suggestive of persistent nodal disease and were managed with neck dissections, three of whom had a persistent tumour. All of these patients have remained disease free in the neck (average follow-up 15 months). Among 22 patients without evidence of nodal disease on post-treatment MRI, 2 patients have had recurrence in the neck (average follow-up 26 months).
Concomitant chemoradiation is effective for the treatment of advanced nodal disease in selected patients. Patients without MRI evidence of persistent nodal disease following chemoradiation who were observed had a low incidence (9%) of eventual neck recurrence, whereas those with evidence of persistent nodes on MRI had a 19% likelihood of residual pathologic neck disease. The optimal strategy for the evaluation of the neck following chemoradiation requires further investigation.
本研究旨在确定磁共振成像（MRI）在预测接受放化疗的头颈癌患者持续性淋巴结疾病中的作用。
对38例患有头颈癌且颈部疾病为N2/N3期、接受放化疗并在治疗后6至8周进行了MRI检查的患者进行回顾性病历审查。
16例患者的MRI检查结果提示存在持续性淋巴结疾病，并接受了颈部清扫术，其中3例患者存在持续性肿瘤。所有这些患者颈部均无疾病复发（平均随访15个月）。在22例治疗后MRI未显示淋巴结疾病证据的患者中，有2例患者颈部出现复发（平均随访26个月）。
同步放化疗对部分选定患者的晚期淋巴结疾病治疗有效。在放化疗后未出现MRI证据提示持续性淋巴结疾病而接受观察的患者，最终颈部复发的发生率较低（9%），而MRI显示存在持续性淋巴结的患者，颈部残留病理疾病的可能性为19%。放化疗后颈部评估的最佳策略需要进一步研究。
