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Nodal volume reduction after concurrent chemo- and radiotherapy: correlation between initial CT and histopathologic
R F Labadie1, W G Yarbrough, M C Weissler
1Department of Surgery, University of North Carolina at Chapel Hill, 27599, USA.
AJNR. American Journal of Neuroradiology
|March 1, 2000
Summary
Concurrent chemoradiation significantly reduced head and neck cancer lymph node volume. Over 90% volume reduction in diseased nodes correlated with tumor eradication, aiding decisions on adjuvant surgery.
Area of Science:
- Oncology
- Radiology
- Head and Neck Surgery
Background:
- Concurrent chemoradiation is increasingly used for head and neck squamous cell carcinoma.
- Evaluating CT-based lymph node changes post-treatment is crucial.
Purpose of the Study:
- To assess CT-visible changes in cervical lymph nodes after concurrent chemoradiation.
- To correlate lymph node volume reduction with histopathologic findings.
Main Methods:
- Seven patients with advanced head and neck squamous cell carcinoma received cisplatin and 5-fluorouracil with radiotherapy.
- CT scans before and after treatment measured volumes of diseased (n=19) and normal (n=7) lymph nodes.
- Volume reduction was correlated with histopathology of resected nodes.
Main Results:
- Diseased lymph nodes showed an average volume reduction of 91%, significantly more than normal nodes (55%).
- Extracapsular spread resolved in all treated diseased nodes.
- Histopathology confirmed persistent tumor in only one of 19 diseased nodes.
Conclusions:
- A >90% nodal volume reduction on CT predicts tumor eradication.
- Serial CT scans can guide the need for adjuvant surgical therapy.