Ballonoff Ari, Raben David, Rusthoven Kyle E, Bassetti Michael, Kane Madeleine, Song John I, Chen Changhu
Departments of Radiation Oncology, University of Colorado Denver, Aurora, Colorado 80045-1665, USA.
Laryngoscope. 2008 Jun;118(6):995-8. doi: 10.1097/MLG.0b013e31816a7120.
To evaluate the outcomes of patients with locally advanced head and neck squamous cell carcinoma with N3 neck nodes treated with definitive chemoradiation.
Retrospective review.
Thirty-two patients with nonmetastatic locally advanced head and neck squamous cell carcinoma and N3 neck disease treated with concurrent chemoradiation therapy were evaluated. Overall survival, disease- free survival, locoregional control, and distant control were recorded.
Median follow-up for surviving patients was 25 (range, 3-93) months. Seventeen of 32 (53%) patients failed, 13 in distant sites only, 2 in the neck only, 1 in the neck and a distant site, and 1 in the neck and primary site. The absolute rates of locoregional control and distant control were 88% and 56%, respectively. Actuarial overall survival and disease-free survival at 2 years were 51% and 29%, respectively.
Patients with N3 neck disease treated with chemoradiation experience a very high rate of distant failure. Future studies investigating the role of additional systemic therapy in these patients are warranted.
评估接受根治性放化疗的局部晚期头颈部鳞状细胞癌伴N3颈部淋巴结转移患者的治疗结果。
回顾性研究。
对32例接受同步放化疗的非转移性局部晚期头颈部鳞状细胞癌伴N3颈部疾病患者进行评估。记录总生存期、无病生存期、局部区域控制率和远处控制率。
存活患者的中位随访时间为25（范围3 - 93）个月。32例患者中有17例（53%）出现病情进展，其中仅远处转移13例，仅颈部转移2例，颈部和远处均转移1例，颈部和原发部位均转移1例。局部区域控制率和远处控制率分别为88%和56%。2年时的精算总生存率和无病生存率分别为51%和29%。
接受放化疗的N3颈部疾病患者远处转移失败率非常高。有必要开展进一步研究以探讨在这些患者中增加全身治疗的作用。
