title: Radiographic complete response on post treatment CT imaging eliminates the need for adjuvant neck dissection after treatment for node positive head and neck cancer.
abstract: OBJECTIVE
  The primary purpose of this study was to correlate radiographic response in the neck to clinical outcomes for patients with node positive head and neck cancer.
  
  
  METHODS
  One hundred three patients with stage III/IV node positive cancer were treated with definitive radiotherapy or chemoradiation at a single institution from 1990 to 2004. Follow-up ranged from 8 months to 144 months with a median of 42 months. Posttreatment CT scans were called complete radiographic response (rCR) or partial radiographic response.
  
  
  RESULTS
  Actuarial 36 month rates of survival, control above the clavicles, and nodal control were 66%, 74%, and 90%, respectively. Patients, who had rCR on posttreatment CT scan, who had a neck dissection had a nodal control rate of 94% compared with those without neck dissection of 97%. Patients with partial radiographic response who were treated with neck dissection had a nodal control rate of 94% compared with those without neck dissection of 73%.
  
  
  CONCLUSIONS
  Based on this data, there was no suggestion that neck dissection improved outcome for patients with rCR on posttreatment imaging 4 to 6 weeks after radiation.
authors.affiliation: Department of Radiation Oncology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA. kgreven@wfubmc.edu
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Greven
authors.forename: Daniel W
authors.initials: DW
authors.lastname: Williams
authors.forename: J Dale
authors.initials: JD
authors.lastname: Browne
authors.forename: W Fred
authors.initials: WF
authors.lastname: McGuirt
authors.forename: Douglas R
authors.initials: DR
authors.lastname: White
authors.forename: Ralph B
authors.initials: RB
authors.lastname: D'Agostino
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000532:radiotherapy* / Q000628:therapy; D003131:Combined Modality Therapy; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000628:therapy; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011879:Radiotherapy Dosage; D012307:Risk Factors; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed
chemical_list: D000970:Antineoplastic Agents