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Oral Oncol. 2015 Feb;51(2):195-201. doi: 10.1016/j.oraloncology.2014.11.001. Epub 2014 Nov 28.

Characteristics and kinetics of cervical lymph node regression after radiation therapy for human papillomavirus-associated oropharyngeal carcinoma: quantitative image analysis of post-radiotherapy response.

Author information

1
Departments of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
2
Departments of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
3
Departments of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
4
Departments of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. Electronic address: gbgunn@mdanderson.org.

Abstract

BACKGROUND AND PURPOSE:

We sought to characterize the pattern of lymph node regression and morphology following definitive radiation therapy (RT) for human papilloma virus (HPV)-associated oropharyngeal carcinoma in patients with disease control.

MATERIALS AND METHODS:

Radiographically positive cervical lymph nodes from patients treated with definitive RT for HPV-associated oropharyngeal carcinoma were segmented on initial pre- and subsequent post-RT contrast enhanced CT images. Pre-specified quantitative nodal parameters were calculated. Initial nodal parameter correlates of final nodal size, final nodal volume, and time to <1 cm short-axis diameter were determined.

RESULTS:

Sixty-six radiographically positive lymph node were analyzed in 36 patients. Lymph nodes exhibited initial volume decreases with size stabilization at ∼4 months. Fifteen nodes (23%) underwent complete radiographic response (median 6.4 months following RT; range 2.9-25.6 months). On multivariate time-to-event analysis, initial hypodense/fat component, nodal volume, and short-axis diameter exhibited inverse association, while higher HU standard deviation exhibited a positive association, with reaching <1 cm short-axis diameter (all p<0.05).

CONCLUSIONS:

Our results showed a substantial decrease in nodal volume within the first 1-2 months following RT. These findings support our current nodal imaging paradigm, propose a quantitative methodology, and describe a reference dataset for further validation and comparison studies.

KEYWORDS:

Cervical lymph nodes; HPV; Oropharynx cancer; Quantitative methodology; Radiographic response

[Indexed for MEDLINE]
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