RT Journal Article
T1 Selective use of postoperative neck radiotherapy in oral cavity and oropharynx cancer: a prospective clinical study.
A1 Martínez Carrillo, Miguel
A1 Tovar Martín, Isabel
A1 Martínez Lara, Ildefonso
A1 Ruiz de Almodóvar Rivera, José Mariano
A1 Moral Ávila, Rosario del
K1 Oral cavity and oropharynx cancer
K1 Postoperative radiotherapy
K1 Selective neck irradiation
K1 Lymph node
K1 Neoplasias de la Boca
K1 Neoplasias Orofaríngeas
K1 Radioterapia
K1 Radioterapia Ayuvante
K1 Humanos
K1 Neoplasias de cabeza y cuello
AB BACKGROUNDIn cervical postoperative radiotherapy, the target volume is usually the same as the extension of the previous dissection. We evaluated a protocol of selective irradiation according to the risk estimated for each dissected lymph node level.METHODSEighty patients with oral/oropharyngeal cancer were included in this prospective clinical study between 2005 and 2008. Patients underwent surgery of the primary tumor and cervical dissection, with identification of positive nodal levels, followed by selective postoperative radiotherapy. Three types of selective nodal clinical target volume (CTV) were defined: CTV0, CTV1, and CTV2, with a subclinical disease risk of <10%, 10-25%, and 25% and a prescribed radiation dose of <35 Gy, 50 Gy, and 66-70 Gy, respectively. The localization of node failure was categorized as field, marginal, or outside the irradiated field.RESULTSA consistent pattern of cervical infiltration was observed in 97% of positive dissections. Lymph node failure occurred within a high-risk irradiated area (CTV1-CTV2) in 12 patients, marginal area (CTV1/CTVO) in 1 patient, and non-irradiated low-risk area (CTV0) in 2 patients. The volume of selective lymph node irradiation was below the standard radiation volume in 33 patients (mean of 118.6 cc per patient). This decrease in irradiated volume was associated with greater treatment compliance and reduced secondary toxicity. The three-year actuarial nodal control rate was 80%.CONCLUSIONThis selective postoperative neck irradiation protocol was associated with a similar failure pattern to that observed after standard neck irradiation and achieved a significant reduction in target volume and secondary toxicity.
PB BioMed Central
YR 2013
FD 2013-04-28
LK http://hdl.handle.net/10668/1319
UL http://hdl.handle.net/10668/1319
LA en
NO Martínez Carrillo M, Tovar Martín I, Martínez Lara I, Ruiz de Almodóvar Rivera JM, Del Moral Ávila R. Selective use of postoperative neck radiotherapy in oral cavity and oropharynx cancer: a prospective clinical study. Radiat Oncol. 2013; 8:103
NO Journal Article; Research Support, Non-U.S. Gov't;
DS RISalud
RD Apr 8, 2025