Recurrence of Lymph Node Micrometastases After Radiotherapy for Head and Neck Carcinoma: A Propensity Score-matched Study

Y U Suzuki; Keiichi Jingu; Eiichi Ishida; Takaki Murata; Masaki Kubozono

doi:10.21873/cdp.10022

Recurrence of Lymph Node Micrometastases After Radiotherapy for Head and Neck Carcinoma: A Propensity Score-matched Study

Cancer Diagn Progn. 2021 Jul 3;1(3):165-172. doi: 10.21873/cdp.10022. eCollection 2021 Jul-Aug.

Authors

Y U Suzuki^{1

2}, Keiichi Jingu^{1

2}, Eiichi Ishida^{2

3}, Takaki Murata⁴, Masaki Kubozono⁵

Affiliations

¹ Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan.
² Department of Head and Neck Cancer Center, Tohoku University Hospital, Sendai, Japan.
³ Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.
⁴ Department of Diagnostic Radiology, Tohoku University Graduate School of Medicine, Sendai, Japan.
⁵ Department of Radiation Oncology, Miyagi Prefectural Cancer Center, Natori, Japan.

Abstract

Background: The standard irradiation dose to the elective lymph node area (ELNA) in locally patients with advanced head and neck squamous cell carcinoma (LA-HNSCC) to control lymph node micrometastases (LN-MM) has not changed since it was empirically determined in the 1950s. We investigated the optimal irradiation dose for controlling LN-MM in ELNAs.

Patients and methods: The pattern of recurrence of LA-HNSCC was retrospectively evaluated in patients who underwent concurrent chemoradiotherapy with cisplatin or radiation therapy alone.

Results: In total, 162 patients were enrolled. The median observation period was 34 months. No recurrence was found in ELNAs. After propensity score matching, a cisplatin dose of ≥200 mg/m ² yielded a significantly higher overall survival rate (p≤0.001) and locoregional control rate (p=0.034) than did a dose of <100 mg/m ² .

Conclusion: CCRT with a cisplatin dose of ≥200 mg/m ² can reduce the irradiation dose to 40-44 Gy at 2 Gy per fraction to control LN-MM.

Keywords: Locally advanced head and neck squamous cell carcinoma; cisplatin; elective lymph node area; patterns of recurrence; radiotherapy.