The pattern of relapse and survival of elective irradiation of the upper neck for stage N0 nasopharyngeal carcinoma
<p>Abstract</p> <p>Background</p> <p>To investigate patterns of failure and survival rates of elective irradiation of upper neck in N0 nasopharyngeal carcinoma patients.</p> <p>Methods</p> <p>From February 1996 to November 2002, 97 patients witho...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2012-03-01
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| Series: | Radiation Oncology |
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| Online Access: | http://www.ro-journal.com/content/7/1/35 |
| _version_ | 1811248506222936064 |
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| author | He Xiayun Pan Ziqiang Guo Xiaomao Ye Ming Zhang Zhen He Shaoqin Liu Taifu |
| author_facet | He Xiayun Pan Ziqiang Guo Xiaomao Ye Ming Zhang Zhen He Shaoqin Liu Taifu |
| author_sort | He Xiayun |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>To investigate patterns of failure and survival rates of elective irradiation of upper neck in N0 nasopharyngeal carcinoma patients.</p> <p>Methods</p> <p>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.</p> <p>Results</p> <p>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.</p> <p>Conclusions</p> <p>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.</p> |
| first_indexed | 2024-04-12T15:29:18Z |
| format | Article |
| id | doaj.art-8a1831265b1747568c299af060dcaad0 |
| institution | Directory Open Access Journal |
| issn | 1748-717X |
| language | English |
| last_indexed | 2024-04-12T15:29:18Z |
| publishDate | 2012-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Radiation Oncology |
| spelling | doaj.art-8a1831265b1747568c299af060dcaad02022-12-22T03:27:09ZengBMCRadiation Oncology1748-717X2012-03-01713510.1186/1748-717X-7-35The pattern of relapse and survival of elective irradiation of the upper neck for stage N0 nasopharyngeal carcinomaHe XiayunPan ZiqiangGuo XiaomaoYe MingZhang ZhenHe ShaoqinLiu Taifu<p>Abstract</p> <p>Background</p> <p>To investigate patterns of failure and survival rates of elective irradiation of upper neck in N0 nasopharyngeal carcinoma patients.</p> <p>Methods</p> <p>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.</p> <p>Results</p> <p>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.</p> <p>Conclusions</p> <p>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.</p>http://www.ro-journal.com/content/7/1/35Nasopharyngeal carcinomaRadiotherapyLymph node |
| spellingShingle | He Xiayun Pan Ziqiang Guo Xiaomao Ye Ming Zhang Zhen He Shaoqin Liu Taifu The pattern of relapse and survival of elective irradiation of the upper neck for stage N0 nasopharyngeal carcinoma Radiation Oncology Nasopharyngeal carcinoma Radiotherapy Lymph node |
| title | The pattern of relapse and survival of elective irradiation of the upper neck for stage N0 nasopharyngeal carcinoma |
| title_full | The pattern of relapse and survival of elective irradiation of the upper neck for stage N0 nasopharyngeal carcinoma |
| title_fullStr | The pattern of relapse and survival of elective irradiation of the upper neck for stage N0 nasopharyngeal carcinoma |
| title_full_unstemmed | The pattern of relapse and survival of elective irradiation of the upper neck for stage N0 nasopharyngeal carcinoma |
| title_short | The pattern of relapse and survival of elective irradiation of the upper neck for stage N0 nasopharyngeal carcinoma |
| title_sort | pattern of relapse and survival of elective irradiation of the upper neck for stage n0 nasopharyngeal carcinoma |
| topic | Nasopharyngeal carcinoma Radiotherapy Lymph node |
| url | http://www.ro-journal.com/content/7/1/35 |
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