en بیماری های دهان Oral Medicine پژوهشي Research <p> <strong>Objectives</strong> The optimal management of the N3 neck in head and neck squamous cell carcinoma (HNSCC) remains controversial. We report the outcomes of patients with N3 disease treated with a strategy of concurrent chemo-radiotherapy (CRT)±induction chemotherapy (ICT) without a planned neck dissection. </p><p> <strong>Materials and methods</strong> Forty patients with HNSCC N3 disease treated between January 2004 and December 2010 were retrospectively identified. Inclusion criteria for the study were: non-nasopharyngeal HNSCC, N3 nodal disease, intention to treat with CRT±ICT. </p><p> <strong>Results</strong> Median age was 60 (range 39–74). Median follow up was 32months (range 8–88). 34 (85%) of patients received ICT. 35 patients received cisplatin-CRT, 4 carboplatin-CRT and 1 patient was treated with radiotherapy alone due to ICT toxicity. 27 (67.5%) patients had a complete response (CR) to CRT. 5 (12.5%) patients had an incomplete response in both the primary and nodal sites. 8 (20%) patients had a CR in the primary site but incomplete in the nodal regions. The crude rate of regional failure following a CR was 3/27 (11.2%). Isolated regional failure occurred in 1/27 (3.7%) patients who had achieved a CR post-CRT. 3year overall survival, disease free survival, locoregional control, local control and regional control in the whole cohort were 51.4%, 49.6%, 65.7%, 77.3%, 69.3%, and in patients with a CR were 73.3%, 70.0%, 86.6%, 90.5% and 91.7% respectively. </p><p> <strong>Conclusion</strong> Isolated regional nodal failure is rare following a complete response to CRT for N3 HNSCC managed without a planned neck dissection. </p><hr><p></p><p> <strong>Source: </strong>Journal of Oral Oncology </p><p><a href="http://www.oraloncology.com/article/S1368-8375(12)00238-2/abstract" target="_blank"><font color="#0000ff"> Full Text</font></a> </p> Head and neck neoplasms, Carcinoma, Squamous cell, Neoplasm staging, Chemoradiotherapy, Neck dissection, Treatment outcome 0 0 http://idai.ir/browse.php?a_code=A-10-32-855&slc_lang=en&sid=1 Ebru Karakaya 10031947532846003726 10031947532846003726 Yes Ozlem Yetmen 10031947532846003727 10031947532846003727 No Didem Colpan Oksuz 10031947532846003728 10031947532846003728 No Karen E. Dyker 10031947532846003729 10031947532846003729 No Catherine Coyle 10031947532846003730 10031947532846003730 No Mehmet Sen 10031947532846003731 10031947532846003731 No Robin J.D. Prestwich 10031947532846003732 10031947532846003732 No Department of Clinical Oncology, St. James’s Institute of Oncology, Beckett Street, Leeds LS9 7TF, United Kingdom