局部晚期头颈部癌患者的 upfront 颈清扫术加同期放化疗。
Up-front neck dissection followed by concurrent chemoradiation in patients with regionally advanced head and neck cancer.
机构信息
Department of Radiation Oncology, Wayne State University/Detroit Medical Center, Detroit, Michigan, USA.
出版信息
Head Neck. 2012 Dec;34(12):1798-803. doi: 10.1002/hed.22011. Epub 2012 Feb 6.
BACKGROUND
The appropriate management of the neck in patients with regionally advanced head and neck cancer remains controversial. The purpose of this study was to retrospectively analyze our institutional experience with up-front neck dissection followed by definitive chemoradiotherapy.
METHODS
Fifty-five patients with radiographic evidence of large or necrotic lymph nodes underwent up-front neck dissection followed by definitive chemoradiation.
RESULTS
The 5-year overall survival (OS) and progression-free survival (PFS) rates were estimated at 71.3% and 64.7%, respectively. There were 2 failures in the dissected neck, for a control rate of 96.7%. There were 7 locoregional failures and 12 distant failures, for locoregional and distant control rates of 87.3% and 78.2%, respectively.
CONCLUSION
Up-front neck dissection followed by chemoradiotherapy resulted in excellent locoregional control, OS, and PFS. Utilization of this strategy should be considered in carefully selected patients with regionally advanced head and neck cancer. © 2012 Wiley Periodicals, Inc. Head Neck, 2012.
背景
局部晚期头颈部癌症患者的颈部处理仍存在争议。本研究旨在回顾性分析我们机构采用的初始颈部清扫术加根治性放化疗的经验。
方法
55 例影像学检查显示大或坏死淋巴结的患者接受了初始颈部清扫术加根治性放化疗。
结果
5 年总生存率（OS）和无进展生存率（PFS）分别估计为 71.3%和 64.7%。在清扫的颈部有 2 例失败，控制率为 96.7%。局部区域有 7 例失败，远处有 12 例失败，局部区域和远处控制率分别为 87.3%和 78.2%。
结论
初始颈部清扫术加放化疗可获得极好的局部区域控制、OS 和 PFS。对于局部晚期头颈部癌症的精心选择患者，应考虑采用这种策略。© 2012 Wiley Periodicals, Inc. Head Neck, 2012.
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