| Skin cancer of the head and neck with perineural invasion: defining the clinical target volumes based on the pattern of failure. | |
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MedLine Citation:
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PMID: 18938044 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Iris Gluck; Mohannad Ibrahim; Aron Popovtzer; Theodoros N Teknos; Douglas B Chepeha; Mark E Prince; Jeffrey S Moyer; Carol R Bradford; Avraham Eisbruch |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2008-10-19 |
Journal Detail:
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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:
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Created Date: 2009-04-13 Completed Date: 2009-04-21 Revised Date: 2010-09-21 |
Medline Journal Info:
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Nlm Unique ID: 7603616 Medline TA: Int J Radiat Oncol Biol Phys Country: United States |
Other Details:
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Languages: eng Pagination: 38-46 Citation Subset: IM |
Affiliation:
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Department of Radiation Oncology, University of Michigan, Ann Arbor MI, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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P01 CA059827-130008/CA/NCI NIH HHS |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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