Up-front neck dissection followed by concurrent chemoradiation in patients with regionally advanced head and neck cancer

作者：Paximadis Peter A^*; Christensen Michael E; Dyson Greg; Kamdar Dev P; Sukari Ammar; Lin Ho Sheng; Yoo George H; Kim Harold E

来源：Head and Neck-Journal for the Sciences and Specialties of the Head and Neck, 2012, 34(12): 1798-1803.

DOI：10.1002/hed.22011

• neck dissection
• chemoradiation
• head and neck cancer
• regional metastasis
• oropharyngeal cancer

Background The appropriate management of the neck in patients with regionally advanced head and neck cancer remains controversial. The purpose of this study was to retrospectively analyze our institutional experience with up-front neck dissection followed by definitive chemoradiotherapy. Methods Fifty-five patients with radiographic evidence of large or necrotic lymph nodes underwent up-front neck dissection followed by definitive chemoradiation. Results The 5-year overall survival (OS) and progression-free survival (PFS) rates were estimated at 71.3% and 64.7%, respectively. There were 2 failures in the dissected neck, for a control rate of 96.7%. There were 7 locoregional failures and 12 distant failures, for locoregional and distant control rates of 87.3% and 78.2%, respectively. Conclusion Up-front neck dissection followed by chemoradiotherapy resulted in excellent locoregional control, OS, and PFS. Utilization of this strategy should be considered in carefully selected patients with regionally advanced head and neck cancer.

• 出版日期2012-12