Adams Gerard, Porceddu Sandro V, Pryor David I, Panizza Benedict, Foote Matthew, Rowan Ann, Burmeister Bryan
Princess Alexandra Hospital, Head and Neck Radiation Oncology Cancer Service, Brisbane, Queensland, Australia; University of Queensland, St. Lucia, Queensland, Australia.
Head Neck. 2014 Aug;36(8):1200-6. doi: 10.1002/hed.23434. Epub 2013 Oct 19.
The purpose of this study was to assess whether a positron emission tomography (PET)-directed policy remains appropriate for managing neck nodes (N3; >6 cm) in head and neck squamous cell carcinoma (HNSCC).
All patients with N3 (>6 cm) HNSCC treated with definitive chemoradiotherapy (CRT) at our institution between 2005 and 2012 were included in the analysis. Patients underwent PET assessment before and 12 weeks after CRT. Neck dissections were performed for PET-avid residual nodal abnormalities after complete response at the primary site. Rate of isolated nodal failure (INF) was the primary outcome.
Median follow-up from diagnosis for 33 patients was 30 months (range, 6-76 months). INF occurred in 2 patients (6%) with neck dissections performed in 4 cases (12%). First failure was predominantly distant metastatic (10; 30%).
The rate of INF remains low when following a PET-directed neck management policy after definitive CRT for N3 (>6 cm) HNSCC.
本研究旨在评估正电子发射断层扫描（PET）引导策略对于头颈部鳞状细胞癌（HNSCC）颈部淋巴结（N3；直径>6 cm）管理是否仍然适用。
纳入2005年至2012年间在本机构接受根治性放化疗（CRT）的所有N3（直径>6 cm）HNSCC患者进行分析。患者在CRT前及CRT后12周接受PET评估。对原发部位达到完全缓解后PET显示有残留淋巴结异常的患者进行颈部清扫术。孤立性淋巴结失败（INF）率是主要观察指标。
33例患者从诊断开始的中位随访时间为30个月（范围6 - 76个月）。2例患者发生INF（6%），4例患者进行了颈部清扫术（12%）。首次失败主要为远处转移（10例；30%）。
对于N3（直径>6 cm）HNSCC患者，在根治性CRT后采用PET引导的颈部管理策略时，INF发生率仍然较低。
