Evidence map›Paper›PMID 36060366›Full record

ArticleCureus2022

Characterizing Lymph Node Burden With Elective Unilateral Neck Irradiation in Human Papillomavirus-Positive Tonsil Squamous Cell Carcinoma: Defining the Upper Limits.

Jared H Hara, Stanley I Gutiontov, Sophia Uddin, Ari J Rosenberg, Alexander T Pearson, Zhen Gooi, Elizabeth A Blair, Nishant Agrawal, Everett E Vokes, Daniel T Ginat and 2 more

Abstract read
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In one paragraph

Article in Cureus, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Jared H HaraDepartment of Radiation and Cellular Oncology, The University of Chicago Medicine, Chicago, USA.
Stanley I GutiontovDepartment of Radiation Oncology, Radiation Oncology Associates, Mequon, USA.
Sophia UddinDepartment of Otorhinolaryngology - Head and Neck Surgery, University of Maryland, Baltimore, USA.
Ari J RosenbergDepartment of Medicine, Section of Hematology/Oncology, The University of Chicago Medicine, Chicago, USA.
Alexander T PearsonDepartment of Medicine, Section of Hematology/Oncology, The University of Chicago Medicine, Chicago, USA.
Zhen GooiDepartment of Surgery, Section of Otolaryngology - Head and Neck Surgery, The University of Chicago Medicine, Chicago, USA.
Elizabeth A BlairDepartment of Surgery, Section of Otolaryngology - Head and Neck Surgery, The University of Chicago Medicine, Chicago, USA.
Nishant AgrawalDepartment of Surgery, Section of Otolaryngology - Head and Neck Surgery, The University of Chicago Medicine, Chicago, USA.
Everett E VokesDepartment of Medicine, Section of Hematology/Oncology, The University of Chicago Medicine, Chicago, USA.
Daniel T GinatDepartment of Radiology, The University of Chicago Medicine, Chicago, USA.
Daniel J HarafDepartment of Radiation and Cellular Oncology, The University of Chicago Medicine, Chicago, USA.
Aditya JulooriDepartment of Radiation and Cellular Oncology, The University of Chicago Medicine, Chicago, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objectives Elective unilateral neck irradiation in well-lateralized tonsil carcinoma for N2b disease is controversial. Metrics regarding nodal burden beyond the N-stage to define the upper limit of this de-escalation approach remain limited. We investigated the role of nodal number, level, and volume on outcomes in patients with well-lateralized tonsil carcinoma treated with this approach. Methods A total of 37 patients received radiotherapy (RT) with unilateral neck coverage for well-lateralized tonsil cancer. Of patients, 95% had p16+ disease, and 81% were staged with positron emission tomography/computed tomography. The majority of patients received definitive chemoradiation on prospective de-escalation trials. Ten patients had ipsilateral neck dissections and were treated adjuvantly. The median RT dose to the ipsilateral neck (generally II-IV) was 45 Gy. The effects of nodal number, max dimension, volume, and level on recurrence-free survival (RFS) and overall survival (OS) were to be analyzed via Cox proportional hazards (Cox-PH). Results After a median follow-up of 3.9 years, two-year RFS and two-year OS were 100% and 97%, respectively. Given the 0% contralateral recurrence rate, Cox-PH analysis was not performed. Of patients, 70% were American Joint Committee on Cancer (AJCC) 7th edition N2b, with a median number of nodes, number of nodal levels, max dimension, and volume of two, one, 3.4 cm, and 15.6 cc, respectively. There were several patients with low-lying nodes; aggregate nodal volume measured was up to 85.4 cc. Conclusion Unilateral neck irradiation in well-lateralized tonsil carcinoma resulted in no contralateral recurrence. Nodal volume, level, and number do not seem to have a significant impact on outcomes.

Indexed as

head and neck squamous cell cancerhpv-related oropharyngeal cancerhuman papilloma virusintensity-modulated radiotherapyipsilateral neck radiationoral and oropharyngeal cancerquality of life

Identifiers

PMID36060366
PMCPMC9424785

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.