Long-term regional control in the observed neck following definitive chemoradiation for node-positive oropharyngeal squamous cell cancer

Long-term regional control in the observed neck following definitive chemoradiation for node-positive oropharyngeal squamous cell cancer
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DOI:
10.1002/ijc.28120
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发表时间:
2013-09-01
影响因子:
6.4
通讯作者:
Lee, Nancy Y.
Lee, Nancy Y.
中科院分区:
医学1区
文献类型:
--
作者:
Goenka, Anuj;Morris, Luc G. T.;Lee, Nancy Y.

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传统上,接受放化疗治疗淋巴结阳性口咽鳞状细胞癌 (N+ OPSCC) 的患者在治疗后会进行计划的颈清扫术 (ND)。最近,发现治疗后阴性正电子发射断层扫描(PET)/计算机断层扫描(CT)成像对颈部残留疾病的存在具有很高的阴性预测价值。在这里,我们首次对大型、统一的 N+ OPSCC 患者进行综合分析,这些患者在放化疗后达到基于 PET/CT 的完全缓解 (CR),并接受观察,而不是 ND。 2002年至2009年,302例N+OPSCC患​​者接受70Gy调强放射治疗和同步化疗,接受了包括PET/CT在内的治疗后临床评估。 CR 定义为临床检查和治疗后 PET/CT 没有疾病证据。 ND 保留给患有以下疾病的患者
Traditionally, patients treated with chemoradiotherapy for node-positive oropharyngeal squamous cell carcinoma (N+ OPSCC) have undergone a planned neck dissection (ND) after treatment. Recently, negative post-treatment positron-emission tomography (PET)/computed tomography (CT) imaging has been found to have a high negative predictive value for the presence of residual disease in the neck. Here, we present the first comprehensive analysis of a large, uniform cohort of N+ OPSCC patients achieving a PET/CT-based complete response (CR) after chemoradiotherapy, and undergoing observation, rather than ND. From 2002 to 2009, 302 patients with N+ OPSCC treated with 70 Gy intensity-modulated radiation therapy and concurrent chemotherapy underwent post-treatment clinical assessment including PET/CT. CR was defined as no evidence of disease on clinical examination and post-treatment PET/CT. ND was reserved for patients with