Planned neck dissection after weekly docetaxel and concurrent radiotherapy for advanced oropharyngeal cancer

Toshiki Tomita, Hiroyuki Ozawa, Koji Sakamoto, Ryoichi Fujii, Kaoru Ogawa, Masato Fujii, Taku Yamashita, Seiichi Shinden

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Small oropharyngeal carcinomas with advanced neck metastases (stage N2 or greater) are common. Patients with small T with large N oropharyngeal carcinoma have high rates of local control but lower rates of regional control when treated with chemoradiotherapy. Clinical assessment after chemoradiotherapy cannot ensure the absence of neck disease. In the last 5 years, we have treated patients with T1-2 with N2-3 oropharyngeal carcinoma with weekly docetaxel radiotherapy followed by planned neck dissection (PND). Our objectives were to clarify the pathologically complete response (CR) rate of neck metastasis after weekly docetaxel radiotherapy, to identify the clinical predictor of residual neck disease, and to determine the mobidity of planned neck dissection. After chemoradiotherapy, all 12 patients had a complete response at the primary site. We conducted 15 neck dissections. Of these, 6 (40%) had positive nodes. The pathological CR rate of neck metastasis was 58.3%, whereas overall 2-year neck control rate was 91.7%. These findings lend support to the role of PND after chemoradiotherapy in N2-3 neck disease. After chemoradiotherapy, clinical parameters including TN status, feasibility of chemoradiotherapy, largest lymph node size or size reduction in MRI, did not identify patients with residual neck disease. We conducted selective neck dissection (SND) in 80% of patients. SND as PND appears to be appropriate in this group of patients because of the low incidence of complications. A further cohort study including the comparison of PND nonenforcement group is necessary to clarify the validity of the addition of PND in weekly docetaxel radiotherapy.

Original languageEnglish
Pages (from-to)95-102
Number of pages8
JournalJournal of Otolaryngology of Japan
Volume110
Issue number3
DOIs
Publication statusPublished - 2007 Mar

Fingerprint

docetaxel
Oropharyngeal Neoplasms
Neck Dissection
Radiotherapy
Chemoradiotherapy
Neck
Neoplasm Metastasis
Carcinoma

Keywords

  • Chemoradiation
  • Docetaxel
  • Oropharyngeal carcinoma
  • Planned neck dissection

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Planned neck dissection after weekly docetaxel and concurrent radiotherapy for advanced oropharyngeal cancer. / Tomita, Toshiki; Ozawa, Hiroyuki; Sakamoto, Koji; Fujii, Ryoichi; Ogawa, Kaoru; Fujii, Masato; Yamashita, Taku; Shinden, Seiichi.

In: Journal of Otolaryngology of Japan, Vol. 110, No. 3, 03.2007, p. 95-102.

Research output: Contribution to journalArticle

Tomita, Toshiki ; Ozawa, Hiroyuki ; Sakamoto, Koji ; Fujii, Ryoichi ; Ogawa, Kaoru ; Fujii, Masato ; Yamashita, Taku ; Shinden, Seiichi. / Planned neck dissection after weekly docetaxel and concurrent radiotherapy for advanced oropharyngeal cancer. In: Journal of Otolaryngology of Japan. 2007 ; Vol. 110, No. 3. pp. 95-102.
@article{27df1873015e41f6b20d4e66c7e9197a,
title = "Planned neck dissection after weekly docetaxel and concurrent radiotherapy for advanced oropharyngeal cancer",
abstract = "Small oropharyngeal carcinomas with advanced neck metastases (stage N2 or greater) are common. Patients with small T with large N oropharyngeal carcinoma have high rates of local control but lower rates of regional control when treated with chemoradiotherapy. Clinical assessment after chemoradiotherapy cannot ensure the absence of neck disease. In the last 5 years, we have treated patients with T1-2 with N2-3 oropharyngeal carcinoma with weekly docetaxel radiotherapy followed by planned neck dissection (PND). Our objectives were to clarify the pathologically complete response (CR) rate of neck metastasis after weekly docetaxel radiotherapy, to identify the clinical predictor of residual neck disease, and to determine the mobidity of planned neck dissection. After chemoradiotherapy, all 12 patients had a complete response at the primary site. We conducted 15 neck dissections. Of these, 6 (40{\%}) had positive nodes. The pathological CR rate of neck metastasis was 58.3{\%}, whereas overall 2-year neck control rate was 91.7{\%}. These findings lend support to the role of PND after chemoradiotherapy in N2-3 neck disease. After chemoradiotherapy, clinical parameters including TN status, feasibility of chemoradiotherapy, largest lymph node size or size reduction in MRI, did not identify patients with residual neck disease. We conducted selective neck dissection (SND) in 80{\%} of patients. SND as PND appears to be appropriate in this group of patients because of the low incidence of complications. A further cohort study including the comparison of PND nonenforcement group is necessary to clarify the validity of the addition of PND in weekly docetaxel radiotherapy.",
keywords = "Chemoradiation, Docetaxel, Oropharyngeal carcinoma, Planned neck dissection",
author = "Toshiki Tomita and Hiroyuki Ozawa and Koji Sakamoto and Ryoichi Fujii and Kaoru Ogawa and Masato Fujii and Taku Yamashita and Seiichi Shinden",
year = "2007",
month = "3",
doi = "10.3950/jibiinkoka.110.95",
language = "English",
volume = "110",
pages = "95--102",
journal = "Journal of Otolaryngology of Japan",
issn = "0030-6622",
publisher = "Oto-Rhino-Laryngological Society of Japan Inc.",
number = "3",

}

TY - JOUR

T1 - Planned neck dissection after weekly docetaxel and concurrent radiotherapy for advanced oropharyngeal cancer

AU - Tomita, Toshiki

AU - Ozawa, Hiroyuki

AU - Sakamoto, Koji

AU - Fujii, Ryoichi

AU - Ogawa, Kaoru

AU - Fujii, Masato

AU - Yamashita, Taku

AU - Shinden, Seiichi

PY - 2007/3

Y1 - 2007/3

N2 - Small oropharyngeal carcinomas with advanced neck metastases (stage N2 or greater) are common. Patients with small T with large N oropharyngeal carcinoma have high rates of local control but lower rates of regional control when treated with chemoradiotherapy. Clinical assessment after chemoradiotherapy cannot ensure the absence of neck disease. In the last 5 years, we have treated patients with T1-2 with N2-3 oropharyngeal carcinoma with weekly docetaxel radiotherapy followed by planned neck dissection (PND). Our objectives were to clarify the pathologically complete response (CR) rate of neck metastasis after weekly docetaxel radiotherapy, to identify the clinical predictor of residual neck disease, and to determine the mobidity of planned neck dissection. After chemoradiotherapy, all 12 patients had a complete response at the primary site. We conducted 15 neck dissections. Of these, 6 (40%) had positive nodes. The pathological CR rate of neck metastasis was 58.3%, whereas overall 2-year neck control rate was 91.7%. These findings lend support to the role of PND after chemoradiotherapy in N2-3 neck disease. After chemoradiotherapy, clinical parameters including TN status, feasibility of chemoradiotherapy, largest lymph node size or size reduction in MRI, did not identify patients with residual neck disease. We conducted selective neck dissection (SND) in 80% of patients. SND as PND appears to be appropriate in this group of patients because of the low incidence of complications. A further cohort study including the comparison of PND nonenforcement group is necessary to clarify the validity of the addition of PND in weekly docetaxel radiotherapy.

AB - Small oropharyngeal carcinomas with advanced neck metastases (stage N2 or greater) are common. Patients with small T with large N oropharyngeal carcinoma have high rates of local control but lower rates of regional control when treated with chemoradiotherapy. Clinical assessment after chemoradiotherapy cannot ensure the absence of neck disease. In the last 5 years, we have treated patients with T1-2 with N2-3 oropharyngeal carcinoma with weekly docetaxel radiotherapy followed by planned neck dissection (PND). Our objectives were to clarify the pathologically complete response (CR) rate of neck metastasis after weekly docetaxel radiotherapy, to identify the clinical predictor of residual neck disease, and to determine the mobidity of planned neck dissection. After chemoradiotherapy, all 12 patients had a complete response at the primary site. We conducted 15 neck dissections. Of these, 6 (40%) had positive nodes. The pathological CR rate of neck metastasis was 58.3%, whereas overall 2-year neck control rate was 91.7%. These findings lend support to the role of PND after chemoradiotherapy in N2-3 neck disease. After chemoradiotherapy, clinical parameters including TN status, feasibility of chemoradiotherapy, largest lymph node size or size reduction in MRI, did not identify patients with residual neck disease. We conducted selective neck dissection (SND) in 80% of patients. SND as PND appears to be appropriate in this group of patients because of the low incidence of complications. A further cohort study including the comparison of PND nonenforcement group is necessary to clarify the validity of the addition of PND in weekly docetaxel radiotherapy.

KW - Chemoradiation

KW - Docetaxel

KW - Oropharyngeal carcinoma

KW - Planned neck dissection

UR - http://www.scopus.com/inward/record.url?scp=34248673199&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34248673199&partnerID=8YFLogxK

U2 - 10.3950/jibiinkoka.110.95

DO - 10.3950/jibiinkoka.110.95

M3 - Article

C2 - 17419444

AN - SCOPUS:34248673199

VL - 110

SP - 95

EP - 102

JO - Journal of Otolaryngology of Japan

JF - Journal of Otolaryngology of Japan

SN - 0030-6622

IS - 3

ER -