Matthew E Witek1,2, Neil M Woody3, Hima B Musunuru4, Patrick M Hill1, Poonam Yadav1, Adam R Burr1, Huaising C Ko1, Richard B Ross5, Randall J Kimple1, Paul M Harari1. 1. Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Carbone Cancer Center, Madison, Wisconsin, USA. 2. Department of Radiation Oncology, University of Maryland, School of Medicine, Baltimore, Maryland, USA. 3. Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio, USA. 4. Department of Radiation Oncology, UPMC Hillman Cancer Center, University of Pittsburgh, School of Medicine, Pittsburgh, Pennsylvania, USA. 5. Case Western Reserve University, School of Medicine, Cleveland, Ohio, USA.
Abstract
BACKGROUND: To define the location of the initial contralateral lymph node (LN) metastasis in patients with oropharynx cancer. METHODS: The location of the LN centroids from patients with oropharynx cancer and a single radiographically positive contralateral LN was defined. A clinical target volume (CTV) inclusive of all LN centroids was created, and its impact on dose to organs at risk was assessed. RESULTS: We identified 55 patients of which 49/55 had a single contralateral LN in level IIA, 4/55 in level III, 1/55 in level IIB, and 1/55 in the retropharynx. Mean radiation dose to the contralateral parotid gland was 15.1 and 21.0 Gy, (p <0.001) using the modeled high-risk elective CTV and a consensus CTV, respectively. CONCLUSIONS: We present a systematic approach for identifying the contralateral nodal regions at highest risk of harboring subclinical disease in patients with oropharynx cancer that warrants prospective clinical study.
BACKGROUND: To define the location of the initial contralateral lymph node (LN) metastasis in patients with oropharynx cancer. METHODS: The location of the LN centroids from patients with oropharynx cancer and a single radiographically positive contralateral LN was defined. A clinical target volume (CTV) inclusive of all LN centroids was created, and its impact on dose to organs at risk was assessed. RESULTS: We identified 55 patients of which 49/55 had a single contralateral LN in level IIA, 4/55 in level III, 1/55 in level IIB, and 1/55 in the retropharynx. Mean radiation dose to the contralateral parotid gland was 15.1 and 21.0 Gy, (p <0.001) using the modeled high-risk elective CTV and a consensus CTV, respectively. CONCLUSIONS: We present a systematic approach for identifying the contralateral nodal regions at highest risk of harboring subclinical disease in patients with oropharynx cancer that warrants prospective clinical study.
Authors: Alexander Lin; Erika S Helgeson; Nathaniel S Treister; Brian L Schmidt; Lauren L Patton; Linda S Elting; Rajesh V Lalla; Michael T Brennan; Thomas P Sollecito Journal: Oral Oncol Date: 2022-02-26 Impact factor: 5.337