How to Cite
Abstract
The main purpose of the study was to determine distribution of sentinel lymph nodes in patients with tongue cancer. SPECT-CT visualization of sentinel lymph nodes was performed in 19 primary patients with clinically T1-2N0M0 tongue cancer. SPECT-CT acquisition started 60-120 min after peritumoral injections of 99mTc-nannocolloids (100-150MBq in 0.3-0.4ml). Finally we analyzed lymph flow patterns and localization of lymph nodes with radiocolloids uptake. Bilateral lymph flow from the tongue cancer was detected in 9 (47%) of 19 patients. In 6 cases bilateral pattern was associated with tumors less than 5mm from medial sulcus of the tongue. On the contrary, in 9 of 10 patients with lesions more than 4mm from medial sulcus we detected monolateral lymph-flow. In 4 (21%) of 19 patients SPECT-CT visualized sentinel lymph nodes only in groups Ib-IIa. Modeling of radiotherapy with with standard and lymph-flow guided radiation fields was performed on Eclips treatment planning station. It demonstrated that with lymph-flow guided strategy irradiated volumes can be reduced from 1224 cm3 to 367 cm3, dose to spinal cord can be reduced from 24,7Gy to 14.3Gy, medial dose to contralateral parotid gland - from 24,6Gy to 12,4 Gy. SPECT-CT with radiocolloids can be successfully used for visualization of lymph flow from the primary tumour and subsequent radiotherapy planning.References
Канаев С.В. Новиков С.Н. Роль радионуклидной визуализации путей лимфооттока при определении показаний к облучению парастернальных лимфоузлов // Вопросы онкологии. - 2015. - Т. 61. - № 5. - С. 737-744.
Канаев С.В., Новиков С.Н., Жукова Л.А. и др. Использование данных радионуклидной визуализации индивидуальных путей лимфооттока от новообразований молочной железы для планирования лучевой терапии // Вопр.онкол. - 2011. - Т. 57. - № 5. - С. 616-621.
Крживицкий П.И., Канаев С.В., Новиков С.Н. и др. Применение ОФЭКТ-КТ для визуализации сигнальных лимфатических узлов и путей лимфооттока у больных раком предстательной железы // Вопросы онкологии. - 2016. - Т. 62. - № 2. - С. 272-276.
Криворотько П.В., Табагуа Т.Т., Комяхов А.В. и др. Биопсия сигнальных лимфатических узлов при раннем раке молочной железы: опыт НИИ онкологии им. Н.Н. Петрова // Вопросы онкологии. - 2017. - Т. 63. -№ 2. - С. 267-273.
Al-Mamgani A., Verheij M., van den Brekel M.W.M. Elective unilateral nodal irradiation in head and neck squamous cell carcinoma: A paradigm shift // Eur. J. Cancer. - 2017.
Bilde A., Von Buchwald C., Mortensen J. et al. The role of SPECT-CT in the lymphoscintigraphic identification of sentinel nodes in patients with oral cancer // Acta. Otolaryngol. - 2006. - Vol. 126. - P 1096-1103.
Civantos F.J., Zitsch R.P., Schuller D.E. et al. Sentinel lymph node biopsy accurately stages the regional lymph nodes for T1-T2 oral squamous cell carcinomas: results of a prospective multi-institutional trial // J. Clin. Oncol. - 2010. - Vol. 28(8). - P 1395-1400. - DOI: 10.1200/JC0.2008.20.8777
Daisne J.F., Installe J., Bihin B. et al. SPECT/CT lymphoscintigraphy of sentinel node(s) for superselective prophylactic irradiation of the neck in cN0 head and neck cancer patients: a prospective phase I feasibility study // Radiat. Oncol. - 2014. - Vol. 9. - P 121.
de Bondt R.B., Nelemans P.J., Hofman P.A. et al. Detection of lymph node metastases in head and neck cancer: a meta-analysis comparing US, USgFNAC, CT and MR imaging // Eur. J. Radiol. -2007. - Vol. 64. - P. 266-272.
de Veij Mestdagh P.D., Jonker M.C.J., Vogel W.V. Schreuder W.H. et al. SPECT/CT-guided lymph drainage mapping for the planning of unilateral elective nodal irradiation in head and neck squamous cell carcinoma // Eur. Arch. Otorhinolaryngol. - 2018. - Vol. 275(8). - P. 2135- 2144. - DOI: 10.1007/s00405-018-5050-0
Farmer R.W., McCall L., Civantos F.J. et al. Lymphatic drainage patterns in oral squamous cell carcinoma: findings of the ACOSOG Z0360 (Alliance) study // Otolaryngol. Head Neck Surg. - 2015. - Vol. 152(4). - P. 673-677.
Jellema A.P, Slotman B.J., Doornaert P. et al. Unilateral versus bilateral irradiation in squamous cell head and neck cancer in relation to patient-rated xerostomia and sticky saliva // Radiother Oncol. - 2007. - Vol. 85. - P. 83-89.
Krengli M., Ballare A., Cannillo B. et al. Potential advantage of studying the lymphatic drainage by sentinel node technique and SPECT-Ct image fusion for pelvic irradiation of prostate cancer // Int. J. Radiat. Oncol. Biol. Phys. - 2006. - Vol. 66(4). - P 1100-1104.
Kyzas P.A., Evangelou E., Denaxa-Kyza D., Loannidis J.P 18Ffluorodeoxyglucose positron emission tomography to evaluate cervical node metastases in patients with head and neck squamous cell carcinoma: a meta-analysis // J. Natl. Cancer Inst. - 2008. - Vol. 100. - P 712-720.
Lim Y.C., Lee S.Y, Lim J.Y. et al. Management of contralateral N0 neck in tonsillar squamous cell carcinoma // Laryngoscope. - 2005. - Vol. 115(9). - P 1672-1675.
Liu M., Wang S.J., Yang X., Peng H. Diagnostic Efficacy of Sentinel Lymph Node Biopsy in Early Oral Squamous Cell Carcinoma: A Meta-Analysis of 66 studies // PLoS One. - 2017. - Vol. 12(1). - e0170322. - DOI: 10.1371/journal.pone.0170322
Miura K., Hirakawa H., Uemura H. et al. Sentinel node biopsy for oral cancer: A prospective multicenter Phase II trial // Auris Nasus Larynx. - 2017. - Vol. 44(3). - P 319-326.
Moncayo V.M., Aarsvold J.N., Alazraki N.P Lymphoscintigraphy and Sentinel Nodes // J. Nucl. Med. - 2015. -Vol. 56. - P 901-907.
Novikov S.N., Kanaev S.V., Girshovich M.M. Visualisation of sentinel lymph-nodes - the quide for radiotherapy planning in patients with breast cancer // Eur. J. Nucl. Med. Mol. Imaging. - 2009. - Vol. 36 (suppl. 2). - P 303.-S. 216
Novikov S.N., Krzhivitskii P.I., Radjabova Z.A., Ponomareva O.I., Kanaev S.V. SPECT-CT visualization of sentinel and second echelon lymph nodes for lymph flow guided radiotherapy of tongue cancer Eur J Nucl Med Mol Imaging (2017) 44(Suppl 2): 231. 10.1007/ s00259-017-3822-1 P(S).214 DOI: 10.1007/s00259-017-3822-1
Novikov S.N., Krzhivitskiy P.I., Kanaev S.V., Berlev I.V., Kargopolovaa M.V., Bisyarin M.I., Saveleva V.V. Lymph flow guided irradiation of regional lymph nodes in patients with cervical cancer: Preliminary analysis of scintigraphic data.// Rep Pract Oncol Radiother (2018), doi. org/10.1016/j.rpor. 2018.05.008 DOI: 10.1016/j.rpor.2018.05.008
Olzowy B., Tsalemchuk X., Schotten K.J., Reichel O., Har-reus U. Frequency of bilateral cervical metastases in oropharyngeal squamous cell carcinoma: a retrospective analysis of 352 cases after bilateral neck dissection. Head Neck. 2011 Feb;33(2):239-43.
Sagheb K., Kumar V., Rahimi-Nedjat R., Dollhausen M., Zie-bart T., Al-Nawas B., Walter C. Cervical Metastases Behavior of T1-2 Squamous Cell Carcinoma of the Tongue. J Maxillofac Oral Surg. 2017 Sep;16(3):300-305.
Schilling C., Stoeckli S.J., Haerle S.K.,et al. Sentinel European Node Trial (SENT): 3-year results of sentinel node biopsy in oral cancer. Eur J Cancer. 2015 Dec;51(18):2777-84
Sher David J., Adelstein David J., Gopal K. et al. Radiation therapy for oropharyngeal squamous cell carcinoma: executive summary of an ASTRO evidence-based clinical practice guideline Practical Radiation Oncology (2017) 7, 246-253
Tartaglione G., Stoeckli S.J., de Bree R., et al. Sentinel Node in Oral Cancer: The Nuclear Medicine Aspects. A Survey from the Sentinel European Node TrialClinical Nuclear Medicine. 41(7):534-542
Weiss M.H., Harrison L.B., Isaacs R.S. Use of decision analysis in planning a management strategy for the stage N0 neck. Arch Otolaryngol Head Neck Surg. 1994 Jul;120(7):699-702
Yuen A.P., Ho C.M., Chow T.L., Tang L.C., Cheung W.Y., Ng R.W., Wei W.I., Kong C.K., Book K.S., Yuen W.C., Lam A.K., Yuen N.W., Trendell-Smith N.J., Chan Y.W., Wong B.Y., Li G.K., Ho A.C., Ho W.K., Wong S.X. Yao T.J. Prospective randomized study of selective neck dissection versus observation for N0 neck of early tongue carcinoma. Head Neck. 2009 Jun;31(6):765-72.
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
© АННМО «Вопросы онкологии», Copyright (c) 2019