Y U Suzuki1,2, Keiichi Jingu1,2, Eiichi Ishida2,3, Takaki Murata4, Masaki Kubozono5. 1. Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan. 2. Department of Head and Neck Cancer Center, Tohoku University Hospital, Sendai, Japan. 3. Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan. 4. Department of Diagnostic Radiology, Tohoku University Graduate School of Medicine, Sendai, Japan. 5. Department of Radiation Oncology, Miyagi Prefectural Cancer Center, Natori, Japan.
Abstract
Background: The standard irradiation dose to the elective lymph node area (ELNA) in locally patients with advanced head and neck squamous cell carcinoma (LA-HNSCC) to control lymph node micrometastases (LN-MM) has not changed since it was empirically determined in the 1950s. We investigated the optimal irradiation dose for controlling LN-MM in ELNAs. Patients and Methods: The pattern of recurrence of LA-HNSCC was retrospectively evaluated in patients who underwent concurrent chemoradiotherapy with cisplatin or radiation therapy alone. Results: In total, 162 patients were enrolled. The median observation period was 34 months. No recurrence was found in ELNAs. After propensity score matching, a cisplatin dose of ≥200 mg/m 2 yielded a significantly higher overall survival rate (p≤0.001) and locoregional control rate (p=0.034) than did a dose of <100 mg/m 2 . Conclusion: CCRT with a cisplatin dose of ≥200 mg/m 2 can reduce the irradiation dose to 40-44 Gy at 2 Gy per fraction to control LN-MM. Copyright 2021, International Institute of Anticancer Research.
Background: The standard irradiation dose to the elective lymph node area (ELNA) in locally patients with advanced head and neck squamous cell carcinoma (LA-HNSCC) to control lymph node micrometastases (LN-MM) has not changed since it was empirically determined in the 1950s. We investigated the optimal irradiation dose for controlling LN-MM in ELNAs. Patients and Methods: The pattern of recurrence of LA-HNSCC was retrospectively evaluated in patients who underwent concurrent chemoradiotherapy with cisplatin or radiation therapy alone. Results: In total, 162 patients were enrolled. The median observation period was 34 months. No recurrence was found in ELNAs. After propensity score matching, a cisplatin dose of ≥200 mg/m 2 yielded a significantly higher overall survival rate (p≤0.001) and locoregional control rate (p=0.034) than did a dose of <100 mg/m 2 . Conclusion: CCRT with a cisplatin dose of ≥200 mg/m 2 can reduce the irradiation dose to 40-44 Gy at 2 Gy per fraction to control LN-MM. Copyright 2021, International Institute of Anticancer Research.
Entities:
Keywords:
Locally advanced head and neck squamous cell carcinoma; cisplatin; elective lymph node area; patterns of recurrence; radiotherapy
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