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Published on: April 22, 2019
Recurrence of Lymph Node Micrometastases After Radiotherapy for Head and Neck Carcinoma: A Propensity Score-matched
Y U Suzuki1,2, Keiichi Jingu1,2, Eiichi Ishida2,3
1Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan.
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 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 .
Conclusion:
CCRT with a cisplatin dose of ≥200 mg/m can reduce the irradiation dose to 40-44 Gy at 2 Gy per fraction to control LN-MM.
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