|Title:||Outcome of bimodality definitive chemoradiation does not differ from that of trimodality upfront neck dissection followed by adjuvant treatment for >6 cm lymph node (N3) head and neck cancer||Authors:||Wan-Yu Chen
|Issue Date:||2019||Journal Volume:||14||Journal Issue:||12||Source:||PLoS ONE||Abstract:||
Currently, data regarding optimal treatment modality, response, and outcome specifically for N3 head and neck cancer are limited. This study aimed to compare the treatment outcomes between definitive chemoradiotherapy (CCRT) to the neck and upfront neck dissection followed by adjuvant CCRT. Ninety-three N3 squamous cell carcinoma head and neck cancer patients were included. Primary tumor treatment was divided to definitive CCRT (CCRT group) or curative surgery followed by adjuvant CCRT (surgery group). Neck treatment was also classified into two treatment modalities: definitive CCRT to the neck (CCRT group) or curative neck dissection followed by adjuvant CCRT (neck dissection group). Overall, the 2-year overall survival (OS), local recurrence-free survival (LRFS), regional recurrence-free survival (RRFS), and distant metastasis-free survival (DMFS) were 51.8%, 47.3%, 45.6%, and 43.6%, respectively. In both oropharyngeal cancer and nonoropharyngeal cancer patients, in terms of OS, LRFS, RRFS or DMFS no difference was noted regarding primary tumor treatment (CCRT vs. surgery) or neck treatment (CCRT vs. neck dissection). In summary, N3 neck patients treated with definitive CCRT may achieve similar outcomes to those treated with upfront neck dissection followed by adjuvant CCRT. Caution should be made to avoid overtreatment for this group of patients. ? 2019 Chen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
|URI:||https://scholars.lib.ntu.edu.tw/handle/123456789/557978||ISSN:||1932-6203||DOI:||10.1371/journal.pone.0225962||SDG/Keyword:||bevacizumab; cetuximab; cisplatin; docetaxel; fluorouracil; mitomycin; adjuvant therapy; adult; aged; Article; chemoradiotherapy; comparative effectiveness; distant metastasis free survival; drug effect; drug efficacy; drug response; female; follow up; head and neck cancer; human; local recurrence free survival; major clinical study; male; neck dissection; oropharynx cancer; overall survival; radiation dose; recurrence free survival; regional recurrence free survival; retrospective study; survival rate; treatment outcome; cancer staging; chemoradiotherapy; head and neck tumor; lymph node; middle aged; mortality; multimodality cancer therapy; neck dissection; nuclear magnetic resonance imaging; pathology; prognosis; Adult; Aged; Chemoradiotherapy; Combined Modality Therapy; Female; Head and Neck Neoplasms; Humans; Lymph Nodes; Magnetic Resonance Imaging; Male; Middle Aged; Neck Dissection; Neoplasm Staging; Prognosis; Retrospective Studies; Treatment Outcome
|Appears in Collections:||醫學院附設醫院 (臺大醫院)|
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