Selective use of postoperative neck radiotherapy in oral cavity and oropharynx cancer: a prospective clinical study
| Autor: | Rosario Del Moral Ávila, Ildefonso Martínez Lara, Isabel Tovar Martín, Miguel Martínez Carrillo, José Mariano Ruiz de Almodóvar Rivera |
|---|---|
| Přispěvatelé: | [Martínez Carrillo,M, Tovar Martín,I, Moral Ávila,R del] Department of Radiation Oncology, Virgen de las Nieves University Hospital, Granada, Spain. [Martínez Lara,I] Department of Maxillo-Facial Surgery, Virgen de las Nieves University Hospital, Granada, Spain. [Ruiz de Almodóvar Rivera,JM] Department of Radiology and Physical Medicine, University of Granada, Granada, Spain., This work was supported, in part, by Grants-in-Aid for Scientific Research from the Health Andalusian Authority PI-SAS-209/04. |
| Jazyk: | angličtina |
| Rok vydání: | 2013 |
| Předmět: |
Male
medicine.medical_treatment Oral Surgical Procedures Postoperative radiotherapy Selective neck irradiation Diseases::Neoplasms::Neoplasms by Site::Head and Neck Neoplasms::Otorhinolaryngologic Neoplasms::Pharyngeal Neoplasms::Oropharyngeal Neoplasms [Medical Subject Headings] Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings] Postoperative Period Lymph node Analytical Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Radiotherapy [Medical Subject Headings] Middle Aged Primary tumor Combined Modality Therapy Humanos Dissection Oropharyngeal Neoplasms medicine.anatomical_structure Oncology Radiology Nuclear Medicine and imaging Head and Neck Neoplasms Lymphatic Metastasis Toxicity Carcinoma Squamous Cell Neck Dissection Female Mouth Neoplasms Radiology Adult Neoplasias Orofaríngeas medicine.medical_specialty Neoplasias de cabeza y cuello Oral cavity and oropharynx cancer Radioterapia Ayuvante Radioterapia medicine Humans Radiology Nuclear Medicine and imaging Aged business.industry Squamous Cell Carcinoma of Head and Neck Research Radiotherapy Planning Computer-Assisted Cancer medicine.disease Surgery Radiation therapy Neoplasias de la Boca Diseases::Neoplasms::Neoplasms by Site::Head and Neck Neoplasms::Mouth Neoplasms [Medical Subject Headings] Prospective clinical study Analytical Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Radiotherapy::Radiotherapy Adjuvant [Medical Subject Headings] Radiotherapy Adjuvant business |
| Zdroj: | Radiation Oncology (London, England) Digibug. Repositorio Institucional de la Universidad de Granada instname |
| Popis: | Background: In cervical postoperative radiotherapy, the target volume is usually the same as the extension of the previous dissection. We evaluated a protocol of selective irradiation according to the risk estimated for each dissected lymph node level. Methods: Eighty patients with oral/oropharyngeal cancer were included in this prospective clinical study between 2005 and 2008. Patients underwent surgery of the primary tumor and cervical dissection, with identification of positive nodal levels, followed by selective postoperative radiotherapy. Three types of selective nodal clinical target volume (CTV) were defined: CTV0, CTV1, and CTV2, with a subclinical disease risk of < 10%, 10-25%, and 25% and a prescribed radiation dose of < 35 Gy, 50 Gy, and 66-70 Gy, respectively. The localization of node failure was categorized as field, marginal, or outside the irradiated field. Results: A consistent pattern of cervical infiltration was observed in 97% of positive dissections. Lymph node failure occurred within a high-risk irradiated area (CTV1-CTV2) in 12 patients, marginal area (CTV1/CTVO) in 1 patient, and non-irradiated low-risk area (CTV0) in 2 patients. The volume of selective lymph node irradiation was below the standard radiation volume in 33 patients (mean of 118.6 cc per patient). This decrease in irradiated volume was associated with greater treatment compliance and reduced secondary toxicity. The three-year actuarial nodal control rate was 80%. Conclusion: This selective postoperative neck irradiation protocol was associated with a similar failure pattern to that observed after standard neck irradiation and achieved a significant reduction in target volume and secondary toxicity. This work was supported, in part, by Grants-in-Aid for Scientific Research from the Health Andalusian Authority PI-SAS-209/04. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|