Nodal failure patterns and utility of elective nodal irradiation in submandibular gland carcinoma treated with postoperative radiotherapy - a multicenter experience

Radiation Oncology
Cheng-En HsiehChien-Yu Lin

Abstract

The patterns of nodal relapse in submandibular gland carcinoma (SMGC) patients treated with postoperative radiotherapy (PORT) remain unclear. This study aims to investigate the nodal failure patterns and the utility of elective nodal irradiation (ENI) in SMGC patients undergoing PORT. We retrospectively enrolled 65 SMGC patients who underwent PORT between 2000 and 2014. The nodal failure sites in relation to irradiation fields and pathological parameters were analyzed. ENI regions were categorized into three bilateral echelons (first, levels I-II; second, level III; and third, levels IV-V). Extended ENI was defined as coverage of at least the immediately adjacent uninvolved echelons bilaterally; otherwise, limited ENI was administered. Thirty patients (46%) were stage III-IV, and 18 (28%) were pN+. Neck irradiation included limited (72%) and extended ENI (28%). With a median follow-up of 79 months, 11 patients (17%) developed nodal failures (ipsilateral, N = 6; contralateral, N = 7), 7 (64%) of whom relapsed in the adjacent uninvolved echelons. We identified pN+ (P = 0.030), extranodal extension (ENE, P = 0.002), pT3-4 (P = 0.021), and lymphovascular invasion (LVI, P = 0.004) as significant predictors of contralateral neck recu...Continue Reading

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Citations

Feb 27, 2019·Journal of Cancer Research and Clinical Oncology·Won Ki ChoSang Yoon Kim
Aug 20, 2019·Cancer radiothérapie : journal de la Société française de radiothérapie oncologique·T Frédéric-MoreauM Lapeyre
Apr 27, 2021·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Jessica L GeigerPatrick Ha

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