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

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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

Keywords

  • Chemoradiation
  • Docetaxel
  • Oropharyngeal carcinoma
  • Planned neck dissection

ASJC Scopus subject areas

  • Otorhinolaryngology

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