Neck Dissection Followed by Chemoradiotherapy for Stage IV (N+) Oropharynx Cancer-Reference-Cited by-同舟云学术

Neck Dissection Followed by Chemoradiotherapy for Stage IV (N+) Oropharynx Cancer

Published:2007-09 Issue:3 Volume:137 Page:416-421
ISSN:0194-5998
Container-title:Otolaryngology–Head and Neck Surgery
language:en
Short-container-title:Otolaryngol Head Neck Surg

Author:

Cupino Andrew¹²,Axelrod Rita¹³,Anne P. Rani¹²,Sidhu Kulbir¹²,Lavarino Jorosali¹²,Kung Brian¹⁴,Rosen Marc¹⁴,Keane William¹⁴,Machtay Mitchell¹²

Affiliation:

1. Philadelphia, PA

2. Department of Radiation Oncology, Jefferson Medical College, Thomas Jefferson University, Philadelphia

3. Department of Medical Oncology, Jefferson Medical College, Thomas Jefferson University, Philadelphia

4. Department of Otorhinolaryngology—Head and Neck Surgery, Jefferson Medical College, Thomas Jefferson University, Philadelphia

Abstract

PURPOSE: This study evaluated the strategy of performing neck dissection (ND) without primary tumor resection prior to definitive chemoradiotherapy (CRT) for N2+ oropharynx cancer. METHODS: We analyzed records of 25 patients who underwent ND before concurrent CRT with weekly low-dose concurrent paclitaxel and a platinum compound. The extent of ND was highly customized (1 to 39 nodes) and median radiotherapy dose was 70 Gy. RESULTS: Median follow-up was 36 months. Two-year and 3-year actuarial locoregional control rates were 95% and 88%. No patient had regional neck nodal failure. Two-year rate of freedom from distant metastases was 91%. The 2- and 3-year event-free survival rates were 88% and 75%. Fifteen percent had Grade 3+ late toxicity; none had permanent gastrostomy tube dependence. CONCLUSIONS: Neck dissection without primary tumor resection before definitive chemoradiotherapy for oropharynx cancer is a safe and effective management program and warrants further exploration.

Publisher

SAGE Publications

Subject

Otorhinolaryngology,Surgery

Link

http://journals.sagepub.com/doi/pdf/10.1016/j.otohns.2007.03.021

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