选择性颈部清扫术作为放化疗后临床持续淋巴结疾病的早期挽救性干预措施。
Selective neck dissection as an early salvage intervention for clinically persistent nodal disease following chemoradiation.
机构信息
Division of Otolaryngology-Head and Neck Surgery, Simmons Cancer Institute at Southern Illinois University, Springfield, Illinois.
出版信息
Head Neck. 2012 Feb;34(2):188-93. doi: 10.1002/hed.21707. Epub 2011 Apr 5.
BACKGROUND
The aim of this study was to determine the efficacy of selective neck dissection (SND) performed for persistent nodal disease after chemoradiation.
METHODS
Patients treated with definitive chemoradiation for squamous cell carcinoma of the head and neck who subsequently underwent SND for early salvage of clinically persistent nodal disease were evaluated. The primary outcome measure was regional disease control.
RESULTS
A total of 62 patients underwent 69 SND procedures. The median time interval between completion of chemoradiation and neck dissection was 10 weeks. There was evidence of residual tumor in 32 neck dissection specimens (46%). Forty patients (65%) remained free of disease, whereas the remaining 22 patients (35%) developed a recurrence, among which 4 were regional. Of these, 3 occurred in the contralateral neck and only 1 occurred in the targeted (ipsilateral) neck.
CONCLUSIONS
SND is an effective early salvage intervention for persistent nodal disease in patients treated with chemoradiation.
背景
本研究旨在确定放化疗后持续性淋巴结疾病行选择性颈部清扫术（SND）的疗效。
方法
评估了经根治性放化疗治疗头颈部鳞状细胞癌后，因临床持续性淋巴结疾病而行早期挽救性 SND 的患者。主要结局测量指标为区域性疾病控制。
结果
共有 62 例患者接受了 69 次 SND 手术。放化疗完成与颈部清扫术之间的中位时间间隔为 10 周。32 个颈部清扫标本（46%）中存在残留肿瘤。40 例（65%）患者无疾病残留，而其余 22 例（35%）患者出现复发，其中 4 例为区域性复发。其中，3 例发生在对侧颈部，仅 1 例发生在目标（同侧）颈部。
结论
SND 是放化疗后持续性淋巴结疾病的有效早期挽救干预措施。
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