Nodal XXXX after concurrent chemo- and radiotherapy: correlation between initial CT and histopathologic findings.

@entity1 @entity353 @entity213 @entity5 @entity900 @entity1487
BACKGROUND AND PURPOSE: The role of concurrent chemoradiation for treatment of @entity213 is expanding. We sought to evaluate the CT appearance of diseased and normal cervical lymph nodes before and after concurrent chemoradiation and to correlate lymph node @entity353 as revealed by CT with histopathologic findings of resected nodes. METHODS: Using concurrent chemoradiation, we treated seven @entity1 with locally advanced @entity213 . Our chemotherapeutic regimen consisted of @entity900 (100 mg/m2 body surface area administered on days 1 through 4 and 29 through 32) and @entity1487 (1000 mg/m2 body surface area, administered on days 1 through 4 and 29 through 32). Radiotherapy was administered twice per day on dosing days 1 through 42 to a total dose of 7200 cGy to the @entity5 and 6000 cGy to the involved lymph nodes. Pre- and post-treatment CT scans were used to calculate lymph node volumes for all CT-positive (size criteria or extracapsular spread or both) diseased nodes (n = 19) and one normal node per @entity1 (n = 7). @entity353 was determined by CT results and correlated with the histopathologic findings of resected nodes. RESULTS: Average @entity353 (+/- standard error of the mean) for the 19 diseased nodes was 91%+/-4% and for the seven normal nodes was 55%+/-21% (P < .02, two-sided t test). Fifteen of 19 of the diseased lymph nodes showed extracapsular spread before treatment and none of 19 after treatment. The histopathologic findings of resected nodes included persistent @entity5 in one of the 19 diseased lymph nodes. Six of seven @entity1 remained alive and disease-free, with an average follow-up duration of 24 months. CONCLUSION: Nodal @entity353 of greater than 90% was associated with eradication of @entity5 as assessed by histopathologic analysis of resected nodes. Serial CT scans obtained both before and after concurrent chemoradiation may be useful for predicting which @entity1 will benefit from adjuvant surgical therapy.
