Enhanced control by radiotherapy of cervical lymph node metastases arising from nasopharyngeal carcinoma compared with nodal metastases from other head and neck squamous cell carcinomas
Enhanced control by radiotherapy of cervical lymph node metastases arising from nasopharyngeal carcinoma compared with nodal metastases from other head and neck squamous cell carcinomas
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DOI：
10.1016/s0360-3016(97)00313-1
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发表时间：
1997-08-01
影响因子：
7
通讯作者：
Izard, MA
中科院分区：
文献类型：
--
作者：
Chow, E;Payne, D;Izard, MA
目的：检验鼻咽癌 (NPC) 产生的颈部转移淋巴结比其他头颈部位 (SCC) 鳞状细胞癌 (SCC) 的类似淋巴结更容易通过放疗控制的假设，方法和材料：104 名患有转移性颈部淋巴结的 NPC 患者（最大淋巴结的平均大小等于 4.1 cm）从放射治疗档案中随机选择两个时期，即1969-1976年和1983-1988年，当时仅放射治疗是一线治疗，候选对照是从口咽、下咽、口腔或喉部产生的淋巴结阳性鳞状细胞癌的放射治疗档案中随机选择的，这些癌症在20世纪70年代也接受根治性放射治疗作为唯一的初始治疗，并且 20 世纪 80 年代。以最大受累淋巴结的大小为匹配标准，将每个鼻咽癌病例与对照进行匹配，所有208例患者的中位随访时间为3年（鼻咽癌病例4.2年，匹配对照1.4年），对于末次随访时存活的患者，双臂中位随访7.7年（鼻咽癌病例6.7年，匹配对照10.2年），通过临床颈部检查评估淋巴结控制 在双臂中，淋巴结复发被定义为从放疗治疗第一天起转移性淋巴结疾病复发或持续存在。 结果：尽管对受累颈部淋巴结的平均照射剂量相似（NPC 组为 52.9 Gy，匹配对照为 53.9 Gy），但与 NPC 组相比，SCC 组的淋巴结控制明显较差（p < 0.0001，相对风险 3.0， 95% [1,8, 5.1])，鼻咽癌病例的 3 年淋巴结无复发率为 71 +/- 5%，而匹配对照组为 43 +/- 5%。结论：本研究的结果支持这样的假设：鼻咽癌转移性颈部淋巴结比其他头颈部鳞状细胞产生的类似大小的颈部淋巴结更容易通过放射控制。 癌症，需要进一步研究来探索这种明显放射敏感性的原因，(C) 1997 Elsevier Science Inc.
Purpose: To test the hypothesis that metastatic cervical lymph nodes arising from nasopharyngeal carcinoma (NPC) are more readily controlled with radiotherapy than comparable nodes from squamous cell carcinomas of other head and neck sites (SCC),Methods and Materials: One hundred four NPC patients,vith metastatic cervical nodes (mean size of the largest node equals 4.1 cm) were randomly selected from radiation treatment files for two time periods, 1969-1976 and 1983-1988, when radiation alone was the first line treatment, Candidate controls were selected randomly from radiation treatment files of node positive squamous cell carcinomas arising from the oropharynx, hypopharynx, oral cavity or larynx who were also treated by radical radiation therapy as sole initial treatment in the 1970s and 1980s. Each NPC case was matched with a control using the size of the largest involved node as the matching criterion, The median follow-up of all 208 patients was 3 years (4.2 years in NPC cases and 1.4 years in the matched controls), For those who were alive at last follow-up, the median follow-up for both arms was 7.7 years (6.7 years in NPC cases and 10.2 years in the matched controls), Nodal control was evaluated by clinical neck examination in both arms, Nodal recurrence was defined as relapse or persistence of metastatic nodal disease from day I of radiotherapy treatment,Results: Despite a similar mean delivered dose to involved neck nodes (52.9 Gy for the NPC group and 53.9 Gy for the matched controls), the SCC group had significantly worse nodal control,vith radiation when compared to the NPC group (p < 0.0001, relative risk 3.0, 95% [1,8, 5.1]), The 3-year nodal recurrence-free rate among NPC cases was 71 +/- 5%, compared to 43 +/- 5% among matched controls.Conclusion: The result of this study supports the hypothesis that metastatic cervical nodes from NPC are more readily controlled by irradiation than cervical nodes of similar size arising from other head and neck squamous cell carcinomas, Further study is required to explore the reasons for this apparent radiosensitivity, (C) 1997 Elsevier Science Inc.