Document Detail


Skin cancer of the head and neck with perineural invasion: defining the clinical target volumes based on the pattern of failure.
MedLine Citation:
PMID:  18938044     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To analyze patterns of failure in patients with head-and-neck cutaneous squamous cell carcinoma (HNCSCC) and clinical/radiologic evidence of perineural invasion (CPNI), in order to define neural clinical target volume (CTV) for treatment planning. METHODS AND MATERIALS: Patients treated with three-dimensional (3D) conformal or intensity-modulated radiotherapy (IMRT) for HNCSCC with CPNI were included in the study. A retrospective review of the clinical charts, radiotherapy (RT) plans and radiologic studies has been conducted. RESULTS: Eleven consecutive patients with HNCSCCs with CPNI were treated from 2000 through 2007. Most patients underwent multiple surgical procedures and RT courses. The most prevalent failure pattern was along cranial nerves (CNs), and multiple CNs were ultimately involved in the majority of cases. In all cases the involved CNs at recurrence were the main nerves innervating the primary tumor sites, as well as their major communicating nerves. We have found several distinct patterns of disease spread along specific CNs depending on the skin regions harboring the primary tumors, including multiple branches of CN V and VII. These patterns and the pertinent anatomy are detailed in the this article. CONCLUSIONS: Predictable disease spread patterns along cranial nerves supplying the primary tumor sites were found in this study. Awareness of these patterns, as well as knowledge of the relevant cranial nerve anatomy, should be the basis for CTV definition and delineation for RT treatment planning.
Authors:
Iris Gluck; Mohannad Ibrahim; Aron Popovtzer; Theodoros N Teknos; Douglas B Chepeha; Mark E Prince; Jeffrey S Moyer; Carol R Bradford; Avraham Eisbruch
Related Documents :
3465314 - The intraventricular reservoir in the treatment of neurological disease secondary to he...
15627024 - Recent advances in primary cns lymphoma.
6713344 - Treatment of diffuse poorly differentiated lymphocytic lymphoma. an analysis of prognos...
9577974 - Clinical outcome of pediatric gangliogliomas: ninety-nine cases over 20 years.
3325954 - Current management of low-grade astrocytomas of childhood.
11324954 - Treatment planning for heavy ion radiotherapy: clinical implementation and application.
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-10-19
Journal Detail:
Title:  International journal of radiation oncology, biology, physics     Volume:  74     ISSN:  1879-355X     ISO Abbreviation:  Int. J. Radiat. Oncol. Biol. Phys.     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-04-13     Completed Date:  2009-04-21     Revised Date:  2010-09-21    
Medline Journal Info:
Nlm Unique ID:  7603616     Medline TA:  Int J Radiat Oncol Biol Phys     Country:  United States    
Other Details:
Languages:  eng     Pagination:  38-46     Citation Subset:  IM    
Affiliation:
Department of Radiation Oncology, University of Michigan, Ann Arbor MI, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Carcinoma, Squamous Cell / pathology,  radiotherapy*,  surgery
Cranial Nerves* / pathology
Disease Progression
Female
Head and Neck Neoplasms / pathology,  radiotherapy*,  surgery
Humans
Male
Middle Aged
Neoplasm Invasiveness
Neoplasm Recurrence, Local
Radiotherapy, Conformal
Radiotherapy, Intensity-Modulated
Retrospective Studies
Skin Neoplasms / pathology,  radiotherapy*,  surgery
Treatment Failure
Tumor Burden
Grant Support
ID/Acronym/Agency:
P01 CA059827-130008/CA/NCI NIH HHS
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Trypsin is the culprit of multiple organ injury with severe acute pancreatitis.
Next Document:  Recursive partitioning analysis of prognostic factors for survival in patients with advanced cancer.