The Significance of Residual Disease after External Irradiation of Squamous-Cell Carcinoma of the Oropharynx

Ht, Barkley; Gh, Fletcher

doi:10.1148/124.2.493

Cited by 56 publications

(2 citation statements)

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“…Previous studies have revealed that significant anatomic changes occur during IMRT in patients with head and neck cancer, including weight loss and shrinkage of the primary tumor and nodal mass. 5 , 6 , 8 , 10 Barker et al found that the gross target volumes and parotid glands decreased in volume at a median rate of 1.7% to 1.8% and 0.6%, respectively, per day in the course of radiotherapy. 6 Furthermore, many studies have shown that anatomical changes may influence the dose distribution of target volumes and OARs.…”

Section: Discussionmentioning

confidence: 99%

“… 4 Small variables, including external daily setup variations and internal changes in the anatomy during the IMRT course, could greatly alter the actual dose delivery. 4 Previous studies have revealed that significant anatomic changes, such as weight loss, occurred in the course of IMRT, 6 , 7 , 8 , 9 , 10 which led to significant clinical consequences, including underdose of target volumes and overdose of normal tissues.…”

Section: Introductionmentioning

confidence: 99%

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Is it necessary for clinical tumor volume including neck muscles in target volume delineation of nasopharyngeal carcinoma?

Chen

Kong

et al. 2021

Laryngoscope Investig Oto

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Objectives To calculate the shrinkage of the neck muscles and dosimetric changes and to clarify the necessity of covering part of the muscle in neck node region delineation for patients with nasopharyngeal carcinoma (NPC) treated with intensity‐modulated radiotherapy. Methods In total, 44 patients with NPC were enrolled. Distances between the lateral border of the neck muscles and longitudinal midline were measured on every selected slice. This process was repeated three times, and the mean values of the three distances of planning computed tomography (CT) images and repeated CT images were adopted (labeled d1 and d2). The mean value of the differences between d1 and d2 was regarded as the medial shrinkage of the neck muscles. The initial clinical target volume of cervical lymph nodes (CTV‐n) was shifted medially with the value of shrinkage, yielding a new CTV‐n. Doses that covered 95% of the planning tumor volume (PTV) (D95), 99% of the PTV (D99), mean dose (Dmean), and maximum dose (Dmax) were used to calculate the dosimetric variation between the initial and new CTV‐n. Comparisons were performed using the paired samples t test. Results The median d1 was 3.81 cm (range: 1.19‐8.20 cm), and the median d2 was 3.68 cm (range: 0.94‐9.59 cm), with a statistically significant difference (P < .001). The mean difference between d1 and d2 was 1.5 ± 3.1 mm (SD). The D95 and D99 of PTV of initial CTV‐n decreased by 0.38% and 0.62% (P < .001 and P < .001, respectively). Conclusion Patients with NPC experienced medial shrinkage of the neck muscles by 1.5 mm, and the consequent dose variation was negligible. It is unnecessary to cover part of the muscles in the delineation of the CTV‐n.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Is it necessary for clinical tumor volume including neck muscles in target volume delineation of nasopharyngeal carcinoma?

Chen

Kong

et al. 2021

Laryngoscope Investig Oto

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Advanced Laryngeal Cancer: Relevance of Pathologic Stage to Survival and Therapy

Decker¹,

Price

Goldstein

1986

Archives of Otolaryngology - Head and Neck Surgery

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\s=b\Sixty-seven laryngectomies performed for stage Ill and stage IV laryngeal carcinoma were reviewed. Stage III disease was managed by surgery alone. Treatment of stage IV disease was divided equally between surgery only and surgery plus radiotherapy. Five-year survival rates by clinical stage were 73% for stage III and 39% for stage IV. Clinical underestimation of disease occurred in 25% of stage III lesions. Unrecognized cartilage invasion and nodal disease occurred with equal frequency. Survival rates computed on the basis of pathologic staging were 91% for stage III and 41% for stage IV. Patients with stage IV disease who were treated with surgery alone had a 28% survival rate, while those receiving both radiotherapy and surgery had a 56% survival rate. In our opinion, surgical pathologic staging more accurately predicts survival than does clinical staging. Surgery alone appears to be adequate therapy for pathologic stage III laryngeal cancer. Addition of radiotherapy significantly improves survival in stage IV disease.

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Radiotherapeutic management of bulky cervical lymphadenopathy in squamous cell carcinoma of the head and neck:Is Postradiotherapy Neck Dissection Necessary?

Johnson

Silverman

Clay

et al. 1998

Radiat. Oncol. Investig.

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The Significance of Residual Disease after External Irradiation of Squamous-Cell Carcinoma of the Oropharynx

Cited by 56 publications

References 0 publications

Is it necessary for clinical tumor volume including neck muscles in target volume delineation of nasopharyngeal carcinoma?

Is it necessary for clinical tumor volume including neck muscles in target volume delineation of nasopharyngeal carcinoma?

Advanced Laryngeal Cancer: Relevance of Pathologic Stage to Survival and Therapy

Radiotherapeutic management of bulky cervical lymphadenopathy in squamous cell carcinoma of the head and neck:Is Postradiotherapy Neck Dissection Necessary?

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