Department of Otolaryngology, Fukushima Medical University, Fukushima, Japan.
Department of Otolaryngology, Head and Neck Surgery, School of Medicine, Kanazawa University, Kanazawa, Japan.
Acta Otolaryngol. 2021 Dec;141(12):1063-1069. doi: 10.1080/00016489.2021.2003858. Epub 2021 Nov 26.
Large cervical lymph nodes and the extranodal extension of metastatic lymph nodes are considered poor prognostic factors in head and neck squamous cell carcinoma (HNC).
AIMS/OBJECTIVES: The efficacy of intra-arterial chemotherapy (iaCT) targeting lymph node (LN) in HNC was examined.
We performed a retrospective review of 41 patients with laryngeal and hypopharyngeal cancer showing metastatic cervical LN larger than 20 mm treated with iaCT with concurrent radiotherapy. The administration of cisplatin into LN was divided into three groups: no administration (NO), the same artery as that supplying the primary tumor (SAME), and a different artery from that supplying the primary tumor (DIFFERENT).
A trend toward a more favorable three-year regional control in DIFFERENT compared to NO was observed, although the mean size of LN in DIFFERENT was larger than in the other groups. A better regional control was obtained in both DIFFERENT ( < .05) and DIFFERENT + SAME ( < .05) when overall rather than partial enhancement of lymph node by CT angiography was observed. Extranodal extension could be a factor predicting unfavorable regional control.
CONCLUSIONS/SIGNIFICANCE: Targeting lymph node may be helpful to avoid neck dissection when iaCT was planned in HNC with relatively large LNs.
在头颈部鳞状细胞癌（HNC）中，大的颈部淋巴结和转移性淋巴结的结外延伸被认为是预后不良的因素。
目的/目标：检查针对颈部淋巴结（LN）的动脉内化疗（iaCT）在 HNC 中的疗效。
我们对 41 例接受 iaCT 联合放疗治疗的喉和下咽癌伴转移性颈淋巴结大于 20mm 的患者进行了回顾性研究。将顺铂注入 LN 分为三组：不给予（NO）、与原发肿瘤相同的供应动脉（SAME）和来自原发肿瘤不同的供应动脉（DIFFERENT）。
尽管 DIFFERENT 组的 LN 平均大小大于其他组，但与 NO 相比，DIFFERENT 组的三年局部控制率有更好的趋势。当 CT 血管造影观察到整个淋巴结而不是部分增强时，两种方法（DIFFERENT 和 DIFFERENT+SAME）均能获得更好的局部控制（均<.05）。结外延伸可能是预测局部控制不良的因素。
结论/意义：当计划在 HNC 中进行相对较大的 LN 时，iaCT 可能有助于避免颈清扫术。
