Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, MD, USA.
Head Neck. 2012 Nov;34(11):1640-7. doi: 10.1002/hed.21981. Epub 2012 Jan 20.
To assess volumetric changes of human papillomavirus (HPV)-related lymph nodes (LN) before, during, and after a course of intensity-modulated radiation therapy (IMRT) ± chemotherapy.
Each "pathologic" LN (≥1 cm) was contoured on the available diagnostic/planning CTs before, during each week, and after treatment.
Seventy-nine LNs in 50 patients were identified. Beyond the first week of treatment, 3 patterns of LN change were recorded: consistently shrinking LN (n = 33; 41.8%), inconsistently shrinking LN with temporary enlargement limited to the first week (n = 14; 17.7%), or also during the subsequent weeks (n = 32; 40.5%). Nodal density at planning is highly predictive of group assignment, with a larger mean density for consistently over inconsistently shrinking LNs (p = .009). Also, this grouping predicts the response at the end of treatment.
HPV-related LN behavior during IMRT is extremely variable but somewhat predictable on the basis of nodal density at planning.
评估人乳头瘤病毒（HPV）相关淋巴结（LN）在调强放疗（IMRT）±化疗前后的体积变化。
在治疗前、每一周和治疗后，对可用的诊断/计划 CT 上的每个“病理性”LN（≥1cm）进行轮廓勾画。
在 50 名患者中发现了 79 个 LN。除了治疗的第一周外，还记录了 3 种 LN 变化模式：持续缩小的 LN（n=33；41.8%）、在第一周内暂时增大但随后持续缩小的 LN（n=14；17.7%）或也在随后的几周内增大的 LN（n=32；40.5%）。计划时的淋巴结密度高度预测分组，一致性缩小的 LN 的平均密度明显大于不一致性缩小的 LN（p=0.009）。此外，这种分组也预测了治疗结束时的反应。
HPV 相关 LN 在 IMRT 期间的行为变化非常大，但基于计划时的淋巴结密度，具有一定的可预测性。
