[an error occurred while processing this directive]|[an error occurred while processing this directive]
声门上型喉癌根治性放疗颈部预防照射的靶区勾画
徐艺, 张烨, 易俊林
国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院放疗科 100021
Delineation of prophylactic cervical target volumes in radical radiotherapy for supraglottic laryngeal carcinoma
Xu Yi, Zhang Ye, Yi Junlin
Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Abstract:Intensity-modulated radiotherapy (IMRT) is one of the primary treatments for laryngeal cancer. According to the latest international guidelines, the delineation of lymphatic clinical target volumes (CTV) is performed only on the basis of N stage without considering other impact factors, such as tumor subsite, clinical stage and histopathological differentiation. Besides, the detailed lymph node regions that should be included in CTV are still controversial. In this article, clinical data of cervical surgery were retrospectively analyzed, clinical trials associated with lymph node metastases of supraglottic laryngeal carcinoma were reviewed,the distribution characteristics and risk factors of positive lymph nodes were summarized, aiming to provide reference for the precise delineation of prophylactic CTV in radical radiotherapy for supraglottic laryngeal carcinoma.
Xu Yi,Zhang Ye,Yi Junlin. Delineation of prophylactic cervical target volumes in radical radiotherapy for supraglottic laryngeal carcinoma[J]. Chinese Journal of Radiation Oncology, 2020, 29(11): 1003-1007.
[1] Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015[J]. Ca A Cancer J Clin, 2016, 66(2):115. DOI:10. 3322/caac. 21338. [2] Wolf GT, Fisher SG, Hong WK, et al. Induction chemotherapy plus radiation compared with surgery plus radiation in patients with advanced laryngeal cancer[J]. N Engl J Med, 1991, 324(24):1685-1690. DOI:10. 1056/NEJM199106133242402. [3] Forastiere AA, Goepfert H, Maor M, et al. Concurrent chemotherapy and radiotherapy for organ preservation in advanced laryngeal cancer[J]. N Engl J Med, 2003, 349(22):2091-2098. DOI:10. 1056/NEJMoa031317. [4] Cunsolo EM. Anatomy and physiology of the operated larynx[J]. Acta Otorhinolaryngol Ital, 2010, 30(5):238-243. DOI:10. 1016/j. purol. 2012.11. 007. [5] Vorwerk H, Hess CF. Guidelines for delineation of lymphatic clinical target volumes for high conformal radiotherapy:head and neck region[J]. Radiat Oncol, 2011, 6(1):97. DOI:10. 1186/1748-717X-6-97. [6] Tomik J,Składzieñ JModrzejewski M. Evaluation of cervical lymph node metastasis of 1400 patients with cancer of the larynx[J]. Auris Nasus Larynx, 2001, 28(3):233-240. DOI:10. 1016/s0385-8146(00)00116-4. [7] Mutlu V, Ucuncu H, Altas E, et al. The relationship between the localization, size, stage and histopathology of the primary laryngeal tumor with neck metastasis[J]. Eurasian J Med, 2014, 46(1):1-7. DOI:10. 5152/eajm. 2014. 01. [8] Zinis LORD, Piero Nicolai MD, Davide Tomenzoli MD, et al. The distribution of lymph node metastases in supraglottic squamous cell carcinoma:Therapeutic implications[J]. Head Neck, 2002, 24(10):913-920. DOI:10. 1002/hed. 10152. [9] 马泓智, 冯凌, 李平栋, 等. 中晚期喉癌颈淋巴结转移规律相关因素分析[J]. 中华肿瘤防治杂志, 2015, 22(7):542-547. Ma HZ, Feng L, Li PD, et al. Lymphatic metastatic rules of advanced laryngeal cancer and its correlative factors[J]. Chin J Cancer Prev Treat, 2015, 22(7):542-547. [10] şengülE,aĝlam T,Çevik C, et al. The relationship between the frequency of cervical metastases and tumor related factors in laryngeal cancer and outcome of surgical treatment in these cases[J]. J Clin Experim Inv, 2012, 3(2):214-222. DOI:10. 5799/ahinjs. 01. 2012. 02. 0147. [11] Marks JE, Devineni VR, Harvey J, et al. The risk of contralateral lymphatic metastases for cancers of the larynx and pharynx[J]. Am J Otolaryngol, 1992, 13(1):34. DOI:10. 1016/0196-0709(92)90095-B. [12] Ding W, Liu T, Liang J, et al. Supraglottic squamous cell carcinomas have distinctive clinical features and prognosis based on subregion[J/OL]. PLoS One, 2017, 12(11):e0188322. DOI:10. 1371/journal. pone. 0188322. [13] Yilmaz T, SüsLÜ N, Atay G, et al. The effect of midline crossing of lateral supraglottic cancer on contralateral cervical lymph node metastasis[J]. Acta otolaryngol, 2015, 135(5):484. DOI:10. 3109/00016489. 2014. 986759. [14] Giannini A, Ninu MB, Gallina E, et al. Histopathological parameters and lymphatic metastasis in supraglottic laryngeal carcinoma[J]. Pathologica, 1991, 83(1084):167-175. [15] Ozdek A, Sarac S, Akyol MU, et al. Histopathological predictors of occult lymph node metastases in supraglottic squamous cell carcinomas[J]. Eur Arch Otorhinolaryngol, 2000, 257(4):389-392. DOI:10. 1007/s004050000231. [16] Yilmaz T,Hosal AS,Gedikoĝlu G,et al. Prognostic significance of histopathological parameters in cancer of the larynx[J]. Eur Arch Otorhinolaryngol, 1999, 256(3):139-144. DOI:10. 1007/s004050050127. [17] 李巍, 季文樾, 刘嵘. 声门型喉癌颈淋巴结转移相关因素的研究[J]. 中华耳鼻咽喉头颈外科杂志, 2003, 38(4):304-306. Li W, Ji WY, Liu R. Preliminary study on the correlation factors of cervical lymphatic metastasis of glottic carcinoma[J]. Chin J Otorhinolaryngol. 2003, 38(4):304-306. DOI:10. 3760/j. issn:1673-0860. 2003. 04. 018. [18] Martín VC, Poch BJ, Ortega ml, et al. Clinical and histological indicators predictive of cervical metastases in laryngeal cancer[J]. Acta Otorrinolaringol Esp, 2000, 51(4):330-334. [19] Öztürkcan S,Katilmio H, Ozdemir I, et al. Occult contralateral nodal metastases in supraglottic laryngeal cancer crossing the midline[J]. Eur Arch Otorhinolaryngol, 2009, 266(1):117-120. DOI:10. 1007/s00405-008-0721-x. [20] Ferlito A, Rinaldo A, Silver CE, et al. Neck dissection for laryngeal cancer[J]. J Am College Surg, 2008, 207(4):587. DOI:10. 1016/j. jamcollsurg. 2008. 06. 337. [21] Böttcher A, Olze H, Thieme N, et al. A novel classification scheme for advanced laryngeal cancer midline involvement:implications for the contralateral neck[J]. J Cancer Res Clin Oncol, 2017, 143(8):1605-1612. DOI:10. 1007/s00432-017-2419-1. [22] Amar A, Chedid HM, Franzi SA, et al. Neck dissection in squamous cell carcinoma of the larynx:indication of elective contralateral neck dissection[J]. Braz J Otorhinolaryngol, 2012, 78(2):7-10. DOI:10. 1590/S1808-86942012000200002. [23] Rivière D, Mancini J, Santini L, et al. Lymph-node metastasis following total laryngectomy and total pharyngolaryngectomy for laryngeal and hypopharyngeal squamous cell carcinoma:Frequency, distribution and risk factors[J]. Eur Ann of Otorhinolaryngol Head Neck Dis, 2017, 135(3):163-166. DOI:10. 1016/j. anorl. 2017. 11. 008. [24] Dundar R, Aslan H, Ozbay C, et al. The necessity of dissection of level ⅡB in laryngeal squamous cell carcinoma:a clinical study[J]. Otolaryngol Head Neck Surg, 2012, 146(3):390-394. DOI:10. 1177/0194599811430818. [25] Gross BC, Olsen SM, Lewis JE, et al. Level ⅡB lymph-node metastasis in laryngeal and hypopharyngeal squamous cell carcinoma:single-institution case series and review of the literature[J]. Laryngoscope, 2013, 123(12):3032-3036. DOI:10. 1002/lary. 24198. [26] Sezen OS, Kubilay U, Haytoglu S, et al. Frequency of metastases at the area of the supra retrospinal (level ⅡB) lymph node in laryngeal cancer[J]. Head & Neck, 2007,29(12):1111-1114. DOI:10. 1002/hed. 20646. [27] Coskun H, Erisen L, Basut O, et al. Selective neck dissection for clinically N0 neck in laryngeal cancer:Is dissection of level ⅡB necessary?[J]. Otolaryngol Head Neck Surg, 2004, 131(5):655. DOI:10. 1016/j. otohns. 2004. 04. 014. [28] Lim YC, Choi EC, Lee JS, et al. Is dissection of level IV absolutely necessary in elective lateral neck dissection for clinically N0 laryngeal carcinoma?[J]. Oral Oncol, 2006, 42(1):102-107. DOI:10. 1016/j. oraloncology, 2005. 06. 019. [29] Carlos TC, Hugo FK, et al. Levels Ⅱ and Ⅲ neck dissection for larynx cancer with N0 neck[J]. Braz J Otorhinolaryngol, 2012, 78(5):59-63. DOI:10. 5935/1808-8694. 20120009. [30] Elsheikh MN, Mahfouz ME, Salim EI, et al. Molecular assessment of neck dissections supports preserving level ⅡB lymph nodes in selective neck dissection for laryngeal squamous cell carcinoma with a clinically negative neck[J]. ORL J Otorhinolaryngol Relat Spec, 2006, 68(2):177-184. DOI:10. 1159/000091396. [31] Neto V, Cernea CR, Dedivitis RA, et al. Cervical metastasis on level IV in laryngeal cancer[J]. Acta otorhinolaryngologica Ital, 2014, 34(1):15-18. [32] Buckley JG, MacLennan K. Cervical node metastases in laryngeal and hypopharyngeal cancer:a prospective analysis of prevalence and distribution[J]. Head Neck, 2000, 22(4):380-385. DOI:10. 1002/1097-0347(200007)22:4<380::aid-hed11>3. 0. co;2-e. [33] Gregor RT, Oei SS, Hilgers FJM, et al. Management of cervical metastases in supraglottic cancer[J]. Ann Otol Rhinol Laryngol, 1996, 105(11):845-850. DOI:10. 1177/000348949610501101. [34] Guney E, Yigitbasi OG. Management of N0 neck in T1-T2 unilateral supraglottic cancer[J]. Ann Otol Rhinol Laryngol, 1999, 108(10):998-1003. DOI:10. 1016/S0165-5876(99)00127-5. [35] CaflÂS,Yüce I, YifitbaoÂOG,et al. Is routine bilateral neck dissection absolutely necessary in the management of N0 neck in patients with supraglottic carcinoma?[J]. Eur Arch Otorhinolaryngol, 2007, 264(12):1453-1457. DOI:10. 1007/s00405-007-0384-z. [36] Spencer CR, Gay HA, Haughey BH, et al. Eliminating radiotherapy to the contralateral retropharyngeal and high level Ⅱ lymph nodes in head and neck squamous cell carcinoma is safe and improves quality of life[J]. Cancer, 2014, 120(24):3994-4002. DOI:10. 1002/cncr. 28938. [37] Garas J, Sr MG. Squamous cell carcinoma of the subglottis[J]. Am J Otolaryngol, 2006, 27(1):1-4. DOI:10. 1016/j. amjoto. 2005. 05. 004. [38] DHNCG. Guidelines for radiotherapy in Danish Head and Neck Cancer Group (2018 Version 5)[DB/OL][2019-08-09]. https://www. dahanca. oncology. [39] Chiu RJ, Myers EN, Johnson JT. Efficacy of routine bilateral neck dissection in the management of supra glottic cancer[J]. Otolaryngol Head Neck Surg, 2004, 131(5):485-488. DOI:10. 1016/j. otohns. 2004. 04. 024. [40] Rodrigo JP, Cabanillas R, Franco V, et al. Efficacy of routine bilateral neck dissection in the management of the N0 neck in T1-T2 unilateral supraglottic cancer[J]. Head Neck, 2010, 28(6):534-539. DOI:10. 1002/hed. 20359. [41] Mercante G, Bacciu A, Oretti G, et al. Involvement of Level I Neck Lymph Nodes and Submandibular Gland in Laryngeal and/or Hypopharyngeal Squamous Cell Carcinoma[J]. J Otolaryngol, 2006, 35(2):108. DOI:10. 2310/7070. 2005. 4133. [42] Grégoire V, Coche E, Cosnard G, et al. Selection and delineation of lymph node target volumes in head and neck conformal radiotherapy. Proposal for standardizing terminology and procedure based on the surgical experience[J]. Radiother Oncol, 2000, 56(2):135-150. DOI:10. 1016/S0167-8140(00)00202-4. [43] Roberto C, Santos MD. Involvement of level I neck lymph nodes in advanced squamous carcinoma of the larynx[J]. Ann Otol Rhinol Laryngol, 2002, 110(10):982-984. DOI:10. 1016/j. jaad. 2011. 09. 041. [44] Candela FC, Shah J, Jaques DP, et al. Patterns of cervical node metastases from squamous carcinoma of the larynx[J]. Arch Otolaryngol Head Neck Surg, 1990, 116(4):432-435. DOI:10. 1002/hed. 2880120302. [45] Davidson BJ, Kulkarny V, Delacure MD, et al. Posterior triangle metastases of squamous cell carcinoma of the upper aerodigestive tract[J]. Am J Surg, 1993, 166(4):395-398. DOI:10. 1016/S0002-9610(05)80340-X. [46] Gallo O, Fini-Storchi I, Napolitano L. Treatment of the contralateral negative neck in supraglottic cancer patients with unilateral node metastases (N1-3)[J]. Head Neck, 2000, 22(4):386-392. DOI:10. 1002/1097-0347(200007)22:43. 0. CO;2-5. [47] Lee NY, Lu JJ. Target volume delineation and field setup[M]. New York:Springer, 2013. DOI:10. 1007/978-3-642-28860-9. [48] Dahm JD, Sessions DG, Paniello RC, et al. Primary Subglottic Cancer[J]. Laryngoscope, 1998, 108(5):741-746. DOI:10. 1097/00005537-199805000-00022. [49] Plaat RE, de Bree R, Kuik DJ, et al. Prognostic importance of paratracheal lymph node metastases[J]. Laryngoscope, 2005, 115(9):894-898. DOI:10. 1097/01. mlG. 0000160086. 88523. C6. [50] De Bree R, Leemans CR, Silver CE, et al. Paratracheal lymph-node dissection in cancer of the larynx, hypopharynx, and cervical esophagus:the need for guidelines[J]. Head Neck, 2011, 33(6):912-916. DOI:10. 1002/hed. 21472. [51] Varghese BT, Babu S, Desai KP, et al. Prospective study of outcomes of surgically treated larynx and hypopharyngeal cancers[J]. Indian J Cancer, 2014, 51(2):104-108. DOI:10. 4103/0019-509X. 138140. [52] Gorphe P, Matias M, Moya-Plana A, et al. Results and survival of locally advanced AJCC 7th edition T4a laryngeal squamous cell carcinoma treated with primary total laryngectomy and postoperative radiotherapy[J]. Ann Surg Oncol, 2016, 23(8):2596-2601. DOI:10. 1245/s10434-016-5217-0.