Outcome of bimodality definitive chemoradiation does not differ from that of trimodality upfront neck dissection followed by adjuvant treatment for >6 cm lymph node (N3) head and neck cancer

Autoři: Wan-Yu Chen aff001;  Tseng-Cheng Chen aff004;  Shih-Fan Lai aff001;  Tony Hsiang-Kuang Liang aff001;  Bing-Shen Huang aff005;  Chun-Wei Wang aff001
Působiště autorů: Division of Radiation Oncology, Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan aff001;  Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan aff002;  Cancer Research Center, National Taiwan University College of Medicine, Taipei, Taiwan aff003;  Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University, College of Medicine, Taipei, Taiwan aff004;  Department of Radiation Oncology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan aff005;  Department of Radiology, College of Medicine, National Taiwan University, Taipei, Taiwan aff006
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0225962


Currently, data regarding optimal treatment modality, response, and outcome specifically for N3 head and neck cancer are limited. This study aimed to compare the treatment outcomes between definitive chemoradiotherapy (CCRT) to the neck and upfront neck dissection followed by adjuvant CCRT. Ninety-three N3 squamous cell carcinoma head and neck cancer patients were included. Primary tumor treatment was divided to definitive CCRT (CCRT group) or curative surgery followed by adjuvant CCRT (surgery group). Neck treatment was also classified into two treatment modalities: definitive CCRT to the neck (CCRT group) or curative neck dissection followed by adjuvant CCRT (neck dissection group). Overall, the 2-year overall survival (OS), local recurrence-free survival (LRFS), regional recurrence-free survival (RRFS), and distant metastasis-free survival (DMFS) were 51.8%, 47.3%, 45.6%, and 43.6%, respectively. In both oropharyngeal cancer and nonoropharyngeal cancer patients, in terms of OS, LRFS, RRFS or DMFS no difference was noted regarding primary tumor treatment (CCRT vs. surgery) or neck treatment (CCRT vs. neck dissection). In summary, N3 neck patients treated with definitive CCRT may achieve similar outcomes to those treated with upfront neck dissection followed by adjuvant CCRT. Caution should be made to avoid overtreatment for this group of patients.

Klíčová slova:

Cancer chemotherapy – Cancer treatment – Head and neck cancers – Larynx – Neck – Surgical and invasive medical procedures – Surgical oncology – Oropharynx


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2019 Číslo 12
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