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Individualized elective irradiation of the clinically node-negative neck in definitive radiotherapy for head and neck squamous cell carcinoma

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Cancer Communications 2021年第4期41卷 303-315页

作者： Jia Kou Li Lin Cheng-Yang Jiao Meng-Qiu Tian Guan-Qun Zhou Xue Jiang Jun Ma Zhen-Yu Qi Yao Lu Ying Sun Department of Radiation Oncology Sun Yat-sen University Cancer Center/State Key Laboratory of Oncology in South China/Collaborative Innovation Center for Cancer MedicineGuangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and TherapyGuangzhouGuangdong 510060P.R.China Perception vision medical technology co.LTD GuangzhouGuangdong 510275P.R.China School of Data and Computer Science Sun Yat-sen UniversityGuangdong Province Key Laboratory of Computational ScienceGuangzhouGuangdong 510275P.R.China

Background:Oral cavity(OC),oropharyngeal(OP),hypopharyngeal(HP),and laryngeal(LA)squamous cell carcinoma(SCC)have a high incidence of regional lymph node metastasis(LNM).Elective irradiation for clinically node-negative neck is routinely administered to treat lymph nodes harboring occult ***,the optimal elective irradiation schemes are still *** this study,we aimed to establish individualized elective irradiation schemes for the ipsilateral and contralateral node-negative neck of these four types of ***:From July 2005 to December 2018,793 patients with OC-SCC,464 with OP-SCC,413 with HP-SCC,and 645 with LA-SCC were recruited *** on the actual incidence of LNM and the tumor characteristics,risk factors for contralateral LNM,as well as node level coverage schemes for elective irradiation,were determined using logistic regression ***,we developed a publicly available online tool to facilitate the widespread clinical use of these ***:For the ipsilateral node-negative neck,elective irradiation at levels Ⅰ-Ⅲ for OC-SCC and levels Ⅱ-Ⅳa for OP-,HP-and LA-SCC are generally *** addition,level Ⅶa should be included in patients with *** analyses revealed that posterior hypopharyngeal wall and post-cricoid region involvement were independently associated with level Ⅶa metastasis in HP-SCC(all Pnode-negative neck,multivariate analyses revealed that ipsilateral N2b2-N3,tumors with body midline involvement,and degree of tumor invasion were the independent factors for contralateral LNM(all Pneck irradiation,levels Ⅰ-Ⅱ are recommended for OC-SCC,and additional level Ⅲ is recommended for patients with ipsilateral N3 *** Ⅱ-Ⅲ are recommended for OP-,HP-,and LA-SCC,and additional level Ⅳa is recommended for patients with advanced T or ***,additional level Ⅶa

关键词： clinically node-negative neck elective irradiation head and neck squamous cell carcinoma individualization neck node level

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