The pattern of relapse and survival of elective irradiation of the upper neck for stage N0 nasopharyngeal carcinoma

Radiation Oncology

Taifu Liu³  Shaoqin He³  Zhen Zhang²  Ming Ye¹  Xiaomao Guo³  Ziqiang Pan³  Xiayun He³ 

[1] Department of Radiation Oncology, Renji Hospital, Medical School of Shanghai Jiaotong University, Shanghai, PR China;399 Ling Ling Road, Shanghai 200032, PR China;Department of Oncology, Shanghai Medical College, Fudan University, shanghai 200032, PR China

关键词: Lymph node;    Radiotherapy;    Nasopharyngeal carcinoma;   

Others  :  1160881
DOI  :  10.1186/1748-717X-7-35

 received in 2011-11-06, accepted in 2012-03-19,  发布年份 2012

【 摘 要 】

Background

To investigate patterns of failure and survival rates of elective irradiation of upper neck in N0 nasopharyngeal carcinoma patients.

Methods

From February 1996 to November 2002, 97 patients without cervical lymph node involvement were admitted for radiotherapy alone. Before treatment, each patient underwent enhanced CT of nasopharynx and neck. All patients received radiotherapy to the nasopharynx, skull base, and upper neck drainage areas (including levels II, III, and VA). The upper neck was irradiated to a total dose of 50-56 Gy/25-28 fractions/5-5.6 weeks. For the primary tumor, 22 patients used conventional fractionation for a total dose of 70 Gy/35 fractions/7 weeks, and 75 patients used an accelerated hyperfractionationated schedule for a total dose of 78 Gy/60 fractions/6 weeks.

Results

The median follow-up of these 97 patients was 7.75 years. 10 patients had recurrences in the nasopharynx, 8 had distant metastasis, and 5 had recurrences in the cervical lymph nodes. Among the cervical lymph node failures, the areas of recurrence were in the II drainage areas in 4 patients who had neck dissections afterwards, and in IA drainage areas in 1 patient who also had recurrence in the nasopharynx. The causes of death were recurrence in the nasopharynx for 8 patients, 1 of these also had recurrence in the neck, distant metastases in 8 patients, and non-neoplastic diseases in 3 patients.

Conclusions

The causes of failure of N0 patients with nasopharyngeal carcinoma after radiotherapy alone to the nasopharynx and upper neck were nasopharyngeal recurrence, distant metastasis, and cervical recurrence in order of frequency. Elective irradiation of upper neck (II, III, VA) is advised for stage N0 patients diagnosed by enhanced CT of neck. Cervical recurrence alone is rare, which did not greatly affect the long-term survival after salvage neck dissection.

【 授权许可】

   
2012 He et al; licensee BioMed Central Ltd.

【 图 表 】

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