title: The prognostic value of location and size change of pathological lymph nodes evaluated on CT-scan following radiotherapy in head and neck cancer.
abstract: BACKGROUND
  Overall survival after chemo-radiotherapy (CRT) for head and neck cancer ranges between 50 and 60% after 5 year of follow-up. Local and/or regional recurrence is the most frequent form of therapy failure. The aim of this study is to investigate whether the initial location and size change of pathological lymph nodes as evaluated on Computed Tomography (CT) studies can help predict outcome.
  
  
  METHODS
  One hundred eighty-three patients with lymph node-positive head and neck cancer were treated with radiotherapy (RT) or CRT. CT studies pre- and post-treatment were reviewed for lymph node size and location. Data were correlated with local control, regional control, metastasis free survival, disease free survival and overall survival.
  
  
  RESULTS
  Regarding the risk for distant metastasis, a significant influence was seen for the location of the pathological lymph nodes. The metastatic risk increases when levels IV-V are affected rather than levels I-III. A similar observation is seen for levels VI-VII. Regional control improves with decreasing lymph node diameter and volume as evaluated on CT.
  
  
  CONCLUSIONS
  Both location and size change of pathological lymph nodes are of prognostic value after CRT for head and neck cancer.
authors.affiliation: Department of Radiation Oncology, University Hospitals of Leuven, Herestraat 49, 3000, Leuven, Belgium. Daan.nevens@uzleuven.be.
authors.forename: Daan
authors.initials: D
authors.lastname: Nevens
authors.affiliation: Department of Radiation Oncology, University Hospitals of Leuven, Herestraat 49, 3000, Leuven, Belgium.
authors.forename: Olivier
authors.initials: O
authors.lastname: Vantomme
authors.affiliation: Leuven Biostatistics and Statistical Bioinformatics Centre, University of Leuven, Leuven, Belgium.
authors.forename: Annouschka
authors.initials: A
authors.lastname: Laenen
authors.affiliation: Radiology Department, University Hospitals of Leuven, Leuven, Belgium.
authors.forename: Robert
authors.initials: R
authors.lastname: Hermans
authors.affiliation: Department of Radiation Oncology, University Hospitals of Leuven, Herestraat 49, 3000, Leuven, Belgium.
authors.forename: Sandra
authors.initials: S
authors.lastname: Nuyts
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000532:radiotherapy*; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed / Q000379:methods
keywords: Cancer of the head and neck; Computed tomography; Lymph nodes; Neoplasm recurrence locoregional; Radiotherapy