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头颈部鳞状细胞癌患者同步放化疗后转移性淋巴结的治疗评估。

Treatment evaluation of metastatic lymph nodes after concurrent chemoradiotherapy in patients with head and neck squamous cell carcinoma.

机构信息

Department of Otorhinolaryngology, Head and Neck Surgery, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan.

出版信息

Anticancer Res. 2012 Feb;32(2):595-600.

Abstract

BACKGROUND

Concurrent chemoradiotherapy (CCRT) is used to treat advanced head and neck cancer. The accuracy of evaluating lymph nodes metastases following CCRT is important for subsequent therapy.

PATIENTS AND METHODS

Patients were divided into two groups, the complete response (CR) and the non-CR groups, as determined by imaging and fine-needle aspiration cytology (FNAC) performed 4-8 weeks after the CCRT, and the findings were compared with the clinical characteristics.

RESULTS

The sensitivity and the specificity of each evaluation method were as follows: 52.9% and 74.2%, respectively, for computer tomography (CT) and magnetic resonance imaging (MRI); 88.2% and 66.1% for ultrasonography (US); 35.3% and 96.0% for fluorodeoxyglucose-positron emission tomography (FDG-PET) or PET-CT; and 71.4% and 95.6% for FNAC.

CONCLUSION

To evaluate the response of lymph node(s) treated by CCRT, US is useful as a positive screening tool and FDG-PET and PET-CT as negative screening tools. FNAC is useful in evaluating suspicious lymph nodes in both positive and negative cases.

摘要

背景

同期放化疗(CCRT)被用于治疗晚期头颈部癌症。评估 CCRT 后淋巴结转移的准确性对于后续治疗很重要。

患者和方法

根据 CCRT 后 4-8 周的影像学和细针抽吸细胞学(FNAC)检查结果,将患者分为完全缓解(CR)和非 CR 两组,并将检查结果与临床特征进行比较。

结果

每种评估方法的敏感性和特异性如下:计算机断层扫描(CT)和磁共振成像(MRI)分别为 52.9%和 74.2%;超声为 88.2%和 66.1%;氟脱氧葡萄糖正电子发射断层扫描(FDG-PET)或 PET-CT 为 35.3%和 96.0%;FNAC 为 71.4%和 95.6%。

结论

为了评估 CCRT 治疗的淋巴结反应,超声作为阳性筛查工具很有用,FDG-PET 和 PET-CT 作为阴性筛查工具也很有用。FNAC 对于阳性和阴性病例中可疑淋巴结的评估都很有用。

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