Characteristics and kinetics of cervical lymph node regression after radiation therapy for human papillomavirus-associated oropharyngeal carcinoma: Quantitative image analysis of post-radiotherapy response. Issue 2 (February 2015)

• Record Type: Journal Article
• Authors: Tang, Chad; Fuller, Clifton D.; Garden, Adam S.; Awan, Musaddiq J.; Colen, Rivka R.; Morrison, William H.; Frank, Steven J.; Beadle, Beth M.; Phan, Jack; Sturgis, Erich M.; Zafereo, Mark E.; Weber, Randal S.; Rosenthal, David I.; Gunn, G. Brandon
• Is Part Of: Oral oncology. Volume 51:Issue 2(2015:Feb.)
• Page Start: 195
• Page End: 201
• Publication Date: 2015-02
• Subjects: Mouth -- Cancer -- Periodicals; Mouth -- Tumors -- Periodicals; Mouth Diseases -- Periodicals; Mouth Neoplasms -- Periodicals; Bouche -- Cancer -- Périodiques; Bouche -- Tumeurs -- Périodiques; Tumeurs -- Périodiques; Electronic journals; 616.9943105
• DOI: 10.1016/j.oraloncology.2014.11.001
• Languages: English
• ISSNs: 1368-8375

Abstract

<abstract xml:lang="en" abstract-type="author" id="ab005"> <title id="st075">Summary</title> <sec> <title id="st080">Background and purpose</title> <p id="sp0005">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.</p> </sec> <sec> <title id="st085">Materials and methods</title> <p id="sp0010">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.</p> </sec> <sec> <title id="st090">Results</title> <p id="sp0015">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 <italic>p</italic> <0.05).</p> </sec> <sec> <title id="st095">Conclusions</title> <p id="sp0020">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.</p> </sec> </abstract>