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Characteristics and kinetics of cervical lymph node regression after radiation therapy for human papillomavirus-associated oropharyngeal carcinoma: quantitative image analysis of post-radiotherapy response. Oral Oncol 2015 Feb;51(2):195-201

Date

12/03/2014

Pubmed ID

25444304

Pubmed Central ID

PMC4502963

DOI

10.1016/j.oraloncology.2014.11.001

Scopus ID

2-s2.0-84922580932 (requires institutional sign-in at Scopus site)   13 Citations

Abstract

BACKGROUND AND PURPOSE: We sought to characterize the pattern of lymph node regression and morphology following definitive radiation therapy (RT) for human papilloma virus (HPV)-associated oropharyngeal carcinoma in patients with disease control.

MATERIALS AND METHODS: Radiographically positive cervical lymph nodes from patients treated with definitive RT for HPV-associated oropharyngeal carcinoma were segmented on initial pre- and subsequent post-RT contrast enhanced CT images. Pre-specified quantitative nodal parameters were calculated. Initial nodal parameter correlates of final nodal size, final nodal volume, and time to <1 cm short-axis diameter were determined.

RESULTS: Sixty-six radiographically positive lymph node were analyzed in 36 patients. Lymph nodes exhibited initial volume decreases with size stabilization at ∼4 months. Fifteen nodes (23%) underwent complete radiographic response (median 6.4 months following RT; range 2.9-25.6 months). On multivariate time-to-event analysis, initial hypodense/fat component, nodal volume, and short-axis diameter exhibited inverse association, while higher HU standard deviation exhibited a positive association, with reaching <1 cm short-axis diameter (all p<0.05).

CONCLUSIONS: Our results showed a substantial decrease in nodal volume within the first 1-2 months following RT. These findings support our current nodal imaging paradigm, propose a quantitative methodology, and describe a reference dataset for further validation and comparison studies.

Author List

Tang C, Fuller CD, Garden AS, Awan MJ, Colen RR, Morrison WH, Frank SJ, Beadle BM, Phan J, Sturgis EM, Zafereo ME, Weber RS, Rosenthal DI, Gunn GB

Author

Musaddiq J. Awan MD Assistant Professor in the Radiation Oncology department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Alphapapillomavirus
Female
Humans
Lymphatic Metastasis
Male
Oropharyngeal Neoplasms
Tomography, X-Ray Computed