Volumetric change of human papillomavirus-related neck lymph nodes before, during, and shortly after intensity-modulated radiation therapy

Giuseppe Sanguineti, Francesco Ricchetti, Binbin Wu, Nishant Agrawal, Christine Gourin, Harold Agbahiwe, Shanthi Marur, Stefania Clemente, Todd McNutt, Arlene Forastiere

Research output: Contribution to journalArticle

Abstract

Background. To assess volumetric changes of human papillomavirus (HPV)-related lymph nodes (LN) before, during, and after a course of intensity-modulated radiation therapy (IMRT) ± chemotherapy. Methods. Each "pathologic" LN (≥1 cm) was contoured on the available diagnostic/planning CTs before, during each week, and after treatment. Results. Seventy-nine LNs in 50 patients were identified. Beyond the first week of treatment, 3 patterns of LN change were recorded: consistently shrinking LN (n = 33; 41.8%), inconsistently shrinking LN with temporary enlargement limited to the first week (n = 14; 17.7%), or also during the subsequent weeks (n = 32; 40.5%). Nodal density at planning is highly predictive of group assignment, with a larger mean density for consistently over inconsistently shrinking LNs (p =.009). Also, this grouping predicts the response at the end of treatment. Conclusion. HPV-related LN behavior during IMRT is extremely variable but somewhat predictable on the basis of nodal density at planning.

Original languageEnglish
Pages (from-to)1640-1647
Number of pages8
JournalHead and Neck
Volume34
Issue number11
DOIs
Publication statusPublished - Nov 2012

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Keywords

  • IMRT
  • lymph nodes
  • volumetric change

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Sanguineti, G., Ricchetti, F., Wu, B., Agrawal, N., Gourin, C., Agbahiwe, H., Marur, S., Clemente, S., McNutt, T., & Forastiere, A. (2012). Volumetric change of human papillomavirus-related neck lymph nodes before, during, and shortly after intensity-modulated radiation therapy. Head and Neck, 34(11), 1640-1647. https://doi.org/10.1002/hed.21981