Sparing bilateral neck level IB in oropharyngeal carcinoma and xerostomia outcomes Journal Article
| Authors: | Tam, M.; Riaz, N.; Kannarunimit, D.; Peña, A. P.; Schupak, K. D.; Gelblum, D. Y.; Wolden, S. L.; Rao, S.; Lee, N. Y. |
| Article Title: | Sparing bilateral neck level IB in oropharyngeal carcinoma and xerostomia outcomes |
| Abstract: | Objectives: To assess whether sparing neck-level IB in target delineation of node-positive (N+) oropharyngeal carcinoma (OPC) can improve xerostomia outcomes without compromising locoregional control (LRC). Methods: A total of 125 N+ OPC patients with a median age of 57 years underwent chemoradiation between May 2010 and December 2011. A total of 74% of patients had T1-T2 disease, 26% T3-T4, 16% N1, 8% N2A, 48% N2B, 28% N2C; 53% base of tongue, 41% tonsil, and 6% other. Patients were divided into those who had target delineation sparing of bilateral level IB (the spared cohort) versus no sparing (the treated cohort). Sparing of contralateral high-level II nodes was also performed more consistently in the spared cohort. A prospective xerostomia questionnaire (patient reported) was given at each patient follow-up visit to this cohort of patients to assess late xerostomia. Clinical assessment (observer rated) at each patient follow-up visit was also recorded. Results: The 2-year LRC for the spared and treated cohorts was 97.5% and 93.8%, respectively (median follow-up, 23.2 mo). No locoregional failures occurred outside of treatment fields. The spared cohort experienced significant benefits in patient-reported xerostomia summary scores (P=0.021) and observer-rated xerostomia scores (P=0.006). In addition, there were significant reductions in mean doses to the ipsilateral submandibular gland (63.9 vs. 70.5 Gy; P<0.001), contralateral submandibular gland (45.0 vs. 56.2 Gy; P<0.001), oral cavity (35.9 vs. 45.2 Gy; P<0.001), and contralateral parotid gland (20.0 vs. 24.4 Gy; P<0.001). Conclusions: Target delineation sparing of bilateral level IB nodes in N+ OPC reduced mean doses to salivary organs without compromising LRC. Patients with reduced target volumes had better patient-reported xerostomia outcomes. © Copyright © 2014 Wolters Kluwer Health, Inc. All rights reserved. |
| Keywords: | adult; treatment outcome; aged; major clinical study; overall survival; cancer radiotherapy; follow up; cohort analysis; distant metastasis; lymph node; xerostomia; salivary glands; parotid gland; oropharynx carcinoma; mouth cavity; oropharyngeal cancer; submandibular gland; radiation dose reduction; human; male; female; article; sparing ib; submandibular glands |
| Journal Title: | American Journal of Clinical Oncology |
| Volume: | 38 |
| Issue: | 4 |
| ISSN: | 0277-3732 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 2015-08-01 |
| Start Page: | 343 |
| End Page: | 347 |
| Language: | English |
| DOI: | 10.1097/coc.0000000000000064 |
| PROVIDER: | scopus |
| PUBMED: | 26208401 |
| PMCID: | PMC5508539 |
| DOI/URL: | |
| Notes: | Export Date: 2 September 2015 -- Source: Scopus |
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