Neck dissection followed by chemoradiotherapy for stage IV (N+) oropharynx cancer

作者：Cupino Andrew; Axelrod Rita; Anne P Rani; Sidhu Kulbir; Lavarino Jorosali; Kung Brian; Rosen Marc; Keane William; Machtay Mitchell^*

来源：Otolaryngology - Head and Neck Surgery, 2007, 137(3): 416-421.

DOI：10.1016/j.otohns.2007.03.021

PURPOSE: This study evaluated the strategy of performing neck dissection (ND) without primary tumor resection prior to definitive chemoradiotherapy (CRT) for N2+ oropharynx cancer.
METHODS: We analyzed records of 25 patients who underwent ND before concurrent CRT with weekly low-dose concurrent paclitaxel and a platinum compound. The extent of ND was highly customized (I to 39 nodes) and median radiotherapy dose was 70 Gy.
RESULTS: Median follow-up was 36 months. Two-year and 3-year actuarial locoregional control rates were 95% and 88%. No patient had regional neck nodal failure. Two-year rate of freedom from distant metastases was 91%. The 2- and 3-year event-free survival rates were 88% and 75%. Fifteen percent had Grade 3+ late toxicity; none had permanent gastrostomy tube dependence.
CONCLUSIONS: Neck dissection without primary tumor resection before definitive chemoradiotherapy for oropharynx cancer is a safe and effective management program and warrants further exploration.

• 出版日期2007-9