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Vol. 74, No. 2, 2012
Issue release date: April 2012
ORL 2012;74:64-69

Planned Neck Dissection before Combined Chemoradiation in Organ Preservation Protocol for N2-N3 of Supraglottic or Hypopharyngeal Carcinoma

Liu X.-K. · Li Q. · Zhang Q. · Su Y. · Shi Y.-X. · Li H. · Zeng Z.-Y. · Guo Z.-M.
Departments of aHead and Neck Surgery, bRadiation Therapy and cChemotherapy, State Key Laboratory of Oncology in South China, Cancer Center, Sun Yat-Sen University, Guangzhou, PR China

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Objective: To investigate the clinical therapeutic outcomes and neck node control of a pretreatment neck dissection in the chemoradiation protocol of organ preservation for N2-N3 of supraglottic and hypopharyngeal carcinoma. Methods: Forty-six patients (group A) with untreated N2 or N3 squamous cell carcinoma of the supraglottis or hypopharynx underwent pretreatment neck dissection in a chemoradiation protocol, while 39 patients (group B) did not undergo pretreatment neck dissection in a chemoradiation protocol. Salvage surgeries were used for local or cervical node residual tumor or recurrence after chemoradiotherapy. Results: In group A, the mean time between neck dissection and chemoradiation was 21 days (range 15-29). Only 3 patients (6.5%) experienced wound complications. A ‘boost' of radiation of 12 Gy was delivered after 33 neck dissections (64.8%) in patients with extracapsular spread. The Kaplan-Meier 5-year overall survival rate was 42.5%. The 5-year overall survival rate and disease-specific survival rate in group A was 42.5 and 46.4%. The rate of neck node control in group A was better than that in group B (86.3 vs. 65.9%, p = 0.02). Conclusions: Pretreatment neck dissection in a chemoradiation protocol for supraglottic or hypopharyngeal carcinoma showed low complication rates, no delay for radiation, optimal radiation doses, and a high nodal disease control.

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  1. Argiris A: Update on chemoradiotherapy for head and neck cancer. Curr Opin Oncol 2002;14:323-329.

    External Resources

  2. Prades JM, Timoshenko AP, Schmitt TH, Delolme MP, Francoz M, Martin C, Saban-Roche L, Martin CH: Planned neck dissection before combined chemoradiation for pyriform sinus carcinoma. Acta Otolaryngol 2008;128:324-328.
  3. Clayman GL, Johnson CJ 2nd, Morrison W, Ginsberg L, Lippman SM: The role of neck dissection after chemoradiotherapy for oropharyngeal cancer with advanced nodal disease. Arch Otolaryngol Head Neck Surg 2001;127:135-139.
  4. Wolf GT, Fisher SG: Effectiveness of salvage neck dissection for advanced regional metastases when induction chemotherapy and radiation are used for organ preservation. Laryngoscope 1992;102:934-939.
  5. Corry J, Smith JG, Peters LJ: The concept of a planned neck dissection is obsolete. Cancer J 2001;7:472-474.
  6. Peters LJ, Webber RS, Morrison WH, et al: Neck surgery in patients with primary oropharyngeal cancer treated by radiotherapy. Head Neck 1996;18:552-559.
  7. Mendenhall WM, Villaret DB, Amdur RJ, et al: Planned neck dissection after definitive radiotherapy for squamous cell carcinoma of the head and neck. Head Neck 2002;24:1012-1018.

    External Resources

  8. Su CK, Bhattacharya J, Wang CC: Role of neck surgery in conjunction with radiation in regional control of node positive cancer of the oropharynx. Am J Clin Oncol 2002;126:950-956.
  9. Stenson KM, Haraf DJ, Pelzer H, et al: The role of cervical lymphadenectomy after aggressive concomitant chemoradiotherapy: the feasibility of selective neck dissection. Arch Otolaryngol Head Neck Surg 2000;126:950-956.
  10. Sassler AM, Esclamado RM, Wolf GT: Surgery after organ preservation therapy. Arch Otolaryngol Head Neck Surg 1995;121:162-165.
  11. Tibbs MK: Wound healing following radiation therapy: a review. Radiother Oncol 1997;42:99-106.
  12. Corey JP, Caldarelli DD, Hutchinson JC, et al: Surgical complications in patients with head and neck cancer receiving chemotherapy. Otolaryngol Head Neck Surg 1986;112:437-439.
  13. Kovacs AF, Eberlein K, Smolarz A, Weidauer S, Rohde S: Organ-preserving treatment in inoperable patients with primary oral and oropharyngeal carcinoma: chances and limitations (in German). Mund Kiefer Gesichtschir 2006;10:168-177.
  14. Shirazi HA, Sivanandan R, Goode R, Fee WE, Kaplan MJ, Pinto HA, Goffinet DR, Le QT: Advanced-staged tonsillar squamous carcinoma: organ preservation versus surgical management of the primary site. Head Neck 2006;28:587-594.

    External Resources

  15. Taguchi T, Tsukuda M, Mikami Y, Matsuda H, Horiuchi C, Yoshida T, Nishimura G, Ishitoya J, Katori H: Concurrent chemoradiotherapy with cisplatin, 5-fluorouracil, methotrexate, and leucovorin in patients with advanced resectable squamous cell carcinoma of the larynx and hypopharynx. Acta Otolaryngol 2006;126:408-413.
  16. Sulman EP, Schwartz DL, Le TT, Ang KK, Morrison WH, Rosenthal DI, Ahamad A, Kies M, Glisson B, Weber R, Garden AS: IMRT reirradiation of head and neck cancer-disease control and morbidity outcomes. Int J Radiat Oncol Biol Phys 2009;73:399-409.

    External Resources

  17. Seung S, Bae J, Solhjem M, Bader S, Gannett D, Hansen EK, Louie J, Underhill K, Cha C: Intensity-modulated radiotherapy for head-and-neck cancer in the community setting. Int J Radiat Oncol Biol Phys 2008;72:1075-1081.

    External Resources

  18. Spezi E, Angelini AL, Romani F, Guido A, Bunkheila F, Ntreta M, Ferri A: Evaluating the influence of the Siemens IGRT carbon fibre tabletop in head and neck IMRT. Radiother Oncol 2008;89:114-122.

    External Resources

  19. Robbins KT, Wong FS, Kumar P, Hartsell WF, Vieira F, Mullins B, et al: Efficacy of targeted chemoradiation and planned selective neck dissection to control bulky nodal disease in advanced head and neck cancer. Arch Otolaryngol Head Neck Surg 1999;125:670-675.
  20. Argiris A, Stenson KM, Brockstein BE, Mittal BB, Pelzer H, Kies MS, et al: Neck dissection in the combined-modality therapy of patients with locoregionally advanced head and neck cancer. Head Neck 2004;26:447-455.
  21. Wang SJ, Wang MB, Yip H, Calcaterra TC: Combined radiotherapy with planned neck dissection for small head and neck cancers with advanced cervical metastases. Laryngoscope 2000;110:1794-1797.
  22. McHam SA, Adelstein DJ, Rybicki LA, Lavertu P, Esclamado RM, Wood BG, et al: Who merits a neck dissection after definitive chemoradiotherapy for N2-N3 squamous cell head and neck cancer? Head Neck 2003;25:791-798.

    External Resources

  23. Kinnaert P: Anatomical variations of the cervical portion of the thoracic duct in man. J Anat 1973;15:45-52.
  24. Maran AG, Amin M, Wilson JA: Radical neck dissection: a 19-year experience. J Laryngol Otol 1989;103:760-764.
  25. Bremke M, Barth PJ, Sesterhenn AM, Budach V, Engenhart-Cabillic R, Werner JA: Prospective study on neck dissection after primary chemoradiation therapy in stage IV pharyngeal cancer. Anticancer Res 2009;29:2645-2653.
  26. Proctor E, Robbins KT, Vieira F, Hanchett C, Sommes G: Postoperative complications after chemoradiation for advanced head and neck cancer. Head Neck 2004;26:272-277.

    External Resources

  27. Smith RV, Goldman Y, Beitler JJ, Wadler SS: Decreased short and long-term swallowing problems with altered radiotherapy dosing used in an organ-sparing protocol for advanced pharyngeal carcinoma. Arch Otolaryngol Head Neck Surg 2004;130:831-836.
  28. Bernier J, Domenge C, Ozsahin M, Matuszewska K, Lefebvre JL, Greiner RH, et al: Postoperative irradiation with or without concomitant chemotherapy for locally advanced head and neck cancer. N Engl J Med 2004;350:1945-1952.

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