Treatment outcomes and feasibility of partial neck irradiation for patients with nasopharyngeal carcinoma with only retropharyngeal lymph node metastasis after intensity-modulated radiotherapy

Head Neck. 2014 Apr;36(4):468-73. doi: 10.1002/hed.23314. Epub 2013 Jun 18.

Abstract

Background: The purpose of this study was to summarize the treatment outcomes and evaluate the feasibility of partial neck irradiation in patients with nasopharyngeal carcinoma (NPC) with only retropharyngeal lymph nodes (RLNs) metastasis.

Methods: Between January 2003 and December 2007, 54 patients with NPC who received partial neck irradiation to levels II, III, and VA and 100 patients who received whole neck irradiation were reviewed.

Results: The 5-year disease free survival (DFS), disease metastasis-free survival, (DMFS) local relapse-free survival (LRFS), and regional relapse-free survival (RRFS) rates were 81.8%, 87.7%, 94.8%, and 98.1%, respectively. The 5-year RRFS and DFS rates for the partial neck irradiation group and whole neck irradiation group were 98.1% versus 98.0% (p = .882), 87.0% vs 77.0% (p = .117), respectively. Partial neck irradiation was not considered a significant prognostic factor for any endpoint in univariate and multivariate analyses.

Conclusion: Partial irradiation of neck levels II, III, and VA might be acceptable for patients with NPC with only RLN metastasis.

Keywords: intensity-modulated radiotherapy; nasopharyngeal carcinoma; partial neck irradiation; recurrence; retropharyngeal lymph node.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Carcinoma / mortality*
  • Carcinoma / pathology
  • Carcinoma / therapy*
  • Chemotherapy, Adjuvant
  • Disease-Free Survival
  • Feasibility Studies
  • Female
  • Humans
  • Lymph Nodes / radiation effects*
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Nasopharyngeal Neoplasms / mortality*
  • Nasopharyngeal Neoplasms / pathology
  • Nasopharyngeal Neoplasms / therapy*
  • Neoplasm Recurrence, Local
  • Prognosis
  • Radiotherapy, Intensity-Modulated*
  • Retrospective Studies
  • Young Adult