Department of Radiation Oncology.
Department of Radiation Oncology.
Ann Oncol. 2011 Nov;22(11):2489-2494. doi: 10.1093/annonc/mdq768. Epub 2011 Mar 1.
This study describes the results of elective irradiation in the N0 neck and tries to identify prognostic factors for regional recurrence.
Between 1985 and 2000, 785 cN0 or pN0 necks were treated with elective nodal irradiation in 619 head and neck squamous cell carcinoma patients.
Regional control at 3 years was 94% in the cN0 (nondissected) neck compared with 97% in the pN0 (dissected) neck and 90% in the ipsilateral compared with 96% in the contralateral neck (P = 0.08 and P = 0.006, respectively). Regional control in the ipsilateral cN0 neck was 78% compared with 96% in the contralateral cN0 neck. Surgical margin of the primary tumor was an additional prognostic factor in all N0 and pN0 necks.
Neck control rates in electively irradiated N0 necks were excellent. Regional control was worse in the cN0 neck compared with the pN0 neck and in the ipsilateral neck compared with the contralateral side. Additionally, in case of positive surgical margins of the primary tumor, elective nodal irradiation should be applied, even in case of a pN0 neck.
本研究描述了 N0 颈部选择性放疗的结果，并试图确定区域性复发的预后因素。
1985 年至 2000 年间，619 例头颈部鳞状细胞癌患者中有 785 例 cN0 或 pN0 颈部接受了选择性淋巴结照射。
3 年时，cN0（未解剖）颈部的区域控制率为 94%，与 pN0（解剖）颈部的 97%和同侧颈部的 90%相比，对侧颈部的 96%（P=0.08 和 P=0.006）。同侧 cN0 颈部的区域控制率为 78%，与对侧 cN0 颈部的 96%相比。在所有 N0 和 pN0 颈部中，肿瘤原发灶的手术切缘是另一个预后因素。
选择性照射 N0 颈部的颈部控制率非常好。与 pN0 颈部相比，cN0 颈部和同侧颈部的区域控制较差。此外，即使在 pN0 颈部，如果肿瘤原发灶的手术切缘阳性，也应进行选择性淋巴结照射。
