Unilateral versus bilateral nodal irradiation: Current evidence in the treatment of squamous cell carcinoma of the head and neck
| Autor: | William M. Mendenhall, Sandra Nuyts, Alfio Ferlito, June Corry, Alessandra Rinaldo, Avrahram Eisbruch, Anne W.M. Lee, Johannes A. Langendijk, Heleen Bollen, Antti Mäkitie, Robert Smee, Primoz Strojan, Remco DeBree |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
toxicity reduction
medicine.medical_specialty nodal volume selection escalation Nodal irradiation medicine.medical_treatment 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Swallowing Radiation oncology medicine Humans Basal cell volume de‐ Head and neck radiotherapy Squamous Cell Carcinoma of Head and Neck business.industry Head and neck cancer Reproducibility of Results medicine.disease 3. Good health Radiation therapy Otorhinolaryngology Head and Neck Neoplasms 030220 oncology & carcinogenesis Carcinoma Squamous Cell head and neck cancer Lymph Nodes Radiology NODAL business |
| Zdroj: | Head & Neck. 43:2807-2821 |
| ISSN: | 1097-0347 1043-3074 |
| DOI: | 10.1002/hed.26713 |
| Popis: | Cancers of the head and neck region often present with nodal involvement. There is a long-standing convention within the community of head and neck radiation oncology to irradiate both sides of the neck electively in almost all cases to include both macroscopic and microscopic disease extension (so called elective nodal volume). International guidelines for the selection and delineation of the elective lymph nodes were published in the early 2000s and were updated recently. However, diagnostic imaging techniques have improved the accuracy and reliability of nodal staging and as a result, small metastases that used to remain undetected and were thus in the past included in the elective nodal volume, will now be included in high-dose volumes. Furthermore, the elective nodal areas are situated close to the parotid glands, the submandibular glands and the swallowing muscles. Therefore, irradiation of a smaller, more selected volume of the elective nodes could reduce treatment-related toxicity. Several researchers consider the current bilateral elective neck irradiation strategies an overtreatment and show growing interest in a unilateral nodal irradiation in selected patients. The aim of this article is to give an overview of the current evidence about the indications and benefits of unilateral nodal irradiation and the use of SPECT/CT-guided nodal irradiation in squamous cell carcinomas of the head and neck. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text