title: Evaluation of nodal response after intra-arterial chemoradiation for node-positive head and neck cancer.
abstract: This retrospective study aimed to compare the accuracy of two nodal evaluation criteria using computed tomography after intra-arterial chemoradiation in node-positive head and neck squamous cell carcinomas. Computed tomography was used to evaluate radiographic nodal response 4-8 weeks after intra-arterial chemoradiation. We compared the accuracy of two different criteria: criterion 1 (radiographic complete response was recorded in the absence of focal abnormalities and if the maximum diameter of the metastatic node was less than 15 mm), and criterion 2 (radiographic complete response was recorded in the absence of focal abnormalities and if the minimum diameter of metastatic nodes was less than 7 mm in level II and if the minimum diameter of metastatic nodes in the rest of the neck was less than 6 mm). Positive predictive values were criterion 1: 69.2%, criterion 2: 47.8%; negative predictive values were criterion 1: 88.5%, criterion 2: 90.5%. Positive likelihood ratios were criterion 1: 7.50, criterion 2: 3.06. The difference between each criteria was statistically significant using McNemar's test (p = 0.0016). Computed tomography evaluation accuracy of nodal response after intra-arterial chemoradiation was comparable to recent reports, and it was feasible to perform salvage neck dissection by computed tomography evaluation for nodal response. We recommend using criterion 1 because of its simplicity and reliability.
authors: Department of Otolaryngology, Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo 060-8638, Japan. t-sakashita@med.hokudai.ac.jp
authors: Tomohiro
authors: T
authors: Sakashita
authors: Akihiro
authors: A
authors: Homma
authors: Nobuhiko
authors: N
authors: Oridate
authors: Hiromitsu
authors: H
authors: Hatakeyama
authors: Satoshi
authors: S
authors: Kano
authors: Takatsugu
authors: T
authors: Mizumachi
authors: Satoshi
authors: S
authors: Fukuda
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D059248:Chemoradiotherapy; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000556:secondary* / Q000628:therapy*; D006801:Humans; D007261:Infusions, Intra-Arterial; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000187:drug effects / Q000528:radiation effects; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents