Management of advanced nodal disease following chemoradiation for head and neck squamous cell carcinoma: Role of magnetic resonance imaging

Doris Lin, Christine M. Glastonbury, Olga Rafaelian, David W. Eisele, Steven J. Wang

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The purpose of this study was to determine the role of magnetic resonance imaging (MRI) to predict persistent nodal disease in head and neck cancer treated with chemoradiation. Methods: Retrospective chart review of 38 patients with head and neck cancer and N2/N3 neck disease who were treated with chemoradiation and who had an MRI 6 to 8 weeks following treatment. Results: Sixteen patients had MRI findings suggestive of persistent nodal disease and were managed with neck dissections, three of whom had a persistent tumour. All of these patients have remained disease free in the neck (average follow-up 15 months). Among 22 patients without evidence of nodal disease on post-treatment MRI, 2 patients have had recurrence in the neck (average follow-up 26 months). Conclusions: Concomitant chemoradiation is effective for the treatment of advanced nodal disease in selected patients. Patients without MRI evidence of persistent nodal disease following chemoradiation who were observed had a low incidence (9%) of eventual neck recurrence, whereas those with evidence of persistent nodes on MRI had a 19% likelihood of residual pathologic neck disease. The optimal strategy for the evaluation of the neck following chemoradiation requires further investigation.

Original languageEnglish (US)
Pages (from-to)350-356
Number of pages7
JournalJournal of Otolaryngology
Volume36
Issue number6
DOIs
StatePublished - Dec 1 2007
Externally publishedYes

Keywords

  • Chemoradiation
  • Head and neck squamous cell carcinoma
  • Lymph node
  • Magnetic resonance imaging
  • Neck dissection

ASJC Scopus subject areas

  • Medicine(all)

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