Neck response to chemoradiotherapy: complete radiographic response correlates with pathologic complete response in locoregionally advanced head and neck cancer

Archives of Otolaryngology--head & Neck Surgery
Alexander LangermanKerstin M Stenson

Abstract

The role of neck dissection following chemoradiotherapy (CRT) for locoregionally advanced head and neck cancer is an area of active debate. Patients who have a complete radiographic response may not need dissection, and the extent of neck dissection necessary for those patients with residual disease is unclear. Retrospective review of data from a prospectively collected database of patients with locoregionally advanced head and neck cancer treated as part of a phase 2 study of induction chemotherapy followed by concurrent CRT. The results of post-CRT neck computed tomography (CT) imaging and pathologic analysis of the neck dissection specimens were compared to evaluate correlation between radiographic and pathologic response. Forty-nine patients underwent 61 hemineck dissections. Overall, 209 neck levels were dissected. Radiologic complete response in the neck was achieved in 39 patients, all of whom had pathologic specimens negative for tumor cells. Ten patients (20%) had a total of 14 neck levels with residual disease on CT imaging. Five (50%) of these 10 patients were found to have residual tumor cells on pathologic analysis. Tumor cells were contained only to those levels found positive on CT imaging; they were present in 7...Continue Reading

Citations

Mar 5, 2013·Surgical Oncology Clinics of North America·Vassiliki SalouraEzra E W Cohen
Apr 26, 2011·International Journal of Radiation Oncology, Biology, Physics·Vincent VandecaveyeRobert Hermans
Jan 31, 2012·International Journal of Radiation Oncology, Biology, Physics·Juliette ThariatAdam S Garden
Feb 12, 2011·International Journal of Radiation Oncology, Biology, Physics·Sébastien ClavelPhuc Felix Nguyen-Tan

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