Single photon emission computed tomography-computed tomography visualization of sentinel lymph nodes for lymph flow guided nodal irradiation in oral tongue cancer.

Autor: Novikov SN; Department of Radiation Oncology & Nuclear Medicine, N.N. Petrov National Medical Research Center of Oncology, St. Petersburg, Russia., Krzhivitskii PI; Department of Radiation Oncology & Nuclear Medicine, N.N. Petrov National Medical Research Center of Oncology, St. Petersburg, Russia., Radgabova ZA; Department of Head and Neck Surgery, N.N. Petrov National Medical Research Center of Oncology, St Petersburg, Russia., Kotov MA; Department of Head and Neck Surgery, N.N. Petrov National Medical Research Center of Oncology, St Petersburg, Russia., Girshovich MM; Department of Radiation Oncology & Nuclear Medicine, N.N. Petrov National Medical Research Center of Oncology, St. Petersburg, Russia., Artemyeva AS; Department of Pathology, N.N. Petrov National Medical Research Center of Oncology, St Petersburg, Russia., Melnik YS; Department of Radiation Oncology & Nuclear Medicine, N.N. Petrov National Medical Research Center of Oncology, St. Petersburg, Russia., Kanaev SV; Department of Radiation Oncology & Nuclear Medicine, N.N. Petrov National Medical Research Center of Oncology, St. Petersburg, Russia.
Jazyk: angličtina
Zdroj: Radiation oncology journal [Radiat Oncol J] 2021 Sep; Vol. 39 (3), pp. 193-201. Date of Electronic Publication: 2021 Sep 24.
DOI: 10.3857/roj.2021.00395
Abstrakt: Purpose: To evaluate correlation of single photon emission computed tomography-computed tomography (SPECT-CT) data on lymph flow (LF) from oral tongue cancer (OC) and the topography of lymph nodes (LN) metastases; to determine the clinical value of lymph flow guided radiotherapy (LFGRT).
Materials and Methods: SPECT-CT visualization of LF from the OC lesions was performed after peritumoral injection of 99mTc-phytate in 26 primary patients with clinical stage cT1-2N0M0 disease. We determined the individual drainage (unilateral/bilateral) from the tumor, and localization of sentinel LNs according to the neck levels. Metastases in LNs were verified with histology and a 2-year follow-up.
Results: SPECT-CT detected bilateral LF in 10 (38.5%) of 26 patients; in 16 (61.5%) cases the drainage was unilateral. Histology revealed LNs metastases in three cases; regional recurrences were diagnosed in other four patients. In all seven observations metastases were located at the same site and level as the sentinel LNs. In eight (30.8%) of 26 patients sentinel LNs were visualized unilaterally at levels Ib-IIa; in five cases, unilaterally at levels I-IIa-III. In these patients, LFGRT demonstrated 59%-70% reduction of irradiated volume, and 26%-42% and 51%-70% decrease of the mean dose to the spinal cord and the contralateral parotid gland. In patients with a bilateral drainage the reduction of doses absorbed by the spinal cord and contralateral parotid gland was 19% and 6%, respectively.
Conclusion: Localization of sentinel LNs determined by SPECT-CT corresponds to the localization of metastatic LNs in terms of side and levels.
Databáze: MEDLINE
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