Craniocaudal spread patterns of retropharyngeal lymph node metastasis in patients with hypopharyngeal carcinoma
Abstract Background The wide adoption of intensity-modulated radiotherapy (RT) renders an extended neck position unnecessary. In this study, the appropriate craniocaudal border of the retropharyngeal lymph node (RPLN) was assessed based on diagnostic and RT images in patients with hypopharyngeal car...
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BMC
2025-05-01
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| Series: | Radiation Oncology |
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| Online Access: | https://doi.org/10.1186/s13014-025-02651-6 |
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| author | Satomi Yoshimi Ryo Toya Mika Nakatake Yoshiyuki Fukugawa Hideki Ishimaru Reiko Ideguchi Hirofumi Koike Yutaro Tasaki Shinya Shiraishi Yorihisa Orita Toshinori Hirai Natsuo Oya |
| author_facet | Satomi Yoshimi Ryo Toya Mika Nakatake Yoshiyuki Fukugawa Hideki Ishimaru Reiko Ideguchi Hirofumi Koike Yutaro Tasaki Shinya Shiraishi Yorihisa Orita Toshinori Hirai Natsuo Oya |
| author_sort | Satomi Yoshimi |
| collection | DOAJ |
| description | Abstract Background The wide adoption of intensity-modulated radiotherapy (RT) renders an extended neck position unnecessary. In this study, the appropriate craniocaudal border of the retropharyngeal lymph node (RPLN) was assessed based on diagnostic and RT images in patients with hypopharyngeal carcinoma (HPC) for recommendation of appropriate target volume for elective nodal irradiation (ENI). Methods Two board-certified radiation oncologists evaluated the craniocaudal spread of RPLN metastases (RPLNMs) and the position of the hyoid bone using magnetic resonance images (diagnostic position) and RT-planning computed tomography simulator images (RT position with neck extension). Results Of the 154 patients in whom 308 sides were assessed, 19 (12.3%) were diagnosed with RPLNMs in 24 (7.8%) sides. The cranial border of the RPLNMs was found above the hard palate on 3 (1.0%) and 1 (0.3%) side, between the hard palate and cranial edge of the C1 body on 10 (3.2%) and 13 (4.2%) sides, and at the C1 body on 11 (3.6%) and 10 (3.2%) sides in the diagnostic and RT positions, respectively. The caudal border of the RPLNMs was observed between the hard palate and caudal edge of the C2 body on 22 (7.1%) and 22 (7.1%) sides, at the C2/3 disk level on 1 (0.3%) and 1 (0.3%) side, and at the C3 body level on 1 (0.3%) and 1 (0.3%) side in the diagnostic and RT positions, respectively. In the 19 patients with RPLNMs, the most common level of the caudal edge of the hyoid bone body was at the C4 body in 10 (52.6%) and C3 body in 8 (42.1%) patients in the diagnostic and RT positions, respectively. Conclusions RPLNMs above the hard palate and below the C2/3 disk level extremely rarely develop in patients with HPC. The cranial edge level of the hyoid bone varied significantly among treatment positions. Regardless of the treatment position, the cranial and caudal borders of the RPLN for ENI should be defined as the hard palate and cranial edge of C3, respectively. |
| format | Article |
| id | doaj-art-dff7ea96ee624f9797d8ae1c55da024b |
| institution | DOAJ |
| issn | 1748-717X |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
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| series | Radiation Oncology |
| spelling | doaj-art-dff7ea96ee624f9797d8ae1c55da024b2025-08-20T03:16:55ZengBMCRadiation Oncology1748-717X2025-05-012011610.1186/s13014-025-02651-6Craniocaudal spread patterns of retropharyngeal lymph node metastasis in patients with hypopharyngeal carcinomaSatomi Yoshimi0Ryo Toya1Mika Nakatake2Yoshiyuki Fukugawa3Hideki Ishimaru4Reiko Ideguchi5Hirofumi Koike6Yutaro Tasaki7Shinya Shiraishi8Yorihisa Orita9Toshinori Hirai10Natsuo Oya11Department of Radiological Sciences, Graduate School of Biomedical Sciences, Nagasaki UniversityDepartment of Radiological Sciences, Graduate School of Biomedical Sciences, Nagasaki UniversityDepartment of Radiological Sciences, Graduate School of Biomedical Sciences, Nagasaki UniversityDepartment of Radiation Oncology, Faculty of Life Sciences, Kumamoto UniversityDepartment of Radiological Sciences, Graduate School of Biomedical Sciences, Nagasaki UniversityDepartment of Radiological Sciences, Graduate School of Biomedical Sciences, Nagasaki UniversityDepartment of Radiological Sciences, Graduate School of Biomedical Sciences, Nagasaki UniversityDepartment of Radiological Sciences, Graduate School of Biomedical Sciences, Nagasaki UniversityDepartment of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto UniversityDepartment of Otolaryngology–Head and Neck Surgery, Faculty of Life Sciences, Kumamoto UniversityDepartment of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto UniversityDepartment of Radiation Oncology, Faculty of Life Sciences, Kumamoto UniversityAbstract Background The wide adoption of intensity-modulated radiotherapy (RT) renders an extended neck position unnecessary. In this study, the appropriate craniocaudal border of the retropharyngeal lymph node (RPLN) was assessed based on diagnostic and RT images in patients with hypopharyngeal carcinoma (HPC) for recommendation of appropriate target volume for elective nodal irradiation (ENI). Methods Two board-certified radiation oncologists evaluated the craniocaudal spread of RPLN metastases (RPLNMs) and the position of the hyoid bone using magnetic resonance images (diagnostic position) and RT-planning computed tomography simulator images (RT position with neck extension). Results Of the 154 patients in whom 308 sides were assessed, 19 (12.3%) were diagnosed with RPLNMs in 24 (7.8%) sides. The cranial border of the RPLNMs was found above the hard palate on 3 (1.0%) and 1 (0.3%) side, between the hard palate and cranial edge of the C1 body on 10 (3.2%) and 13 (4.2%) sides, and at the C1 body on 11 (3.6%) and 10 (3.2%) sides in the diagnostic and RT positions, respectively. The caudal border of the RPLNMs was observed between the hard palate and caudal edge of the C2 body on 22 (7.1%) and 22 (7.1%) sides, at the C2/3 disk level on 1 (0.3%) and 1 (0.3%) side, and at the C3 body level on 1 (0.3%) and 1 (0.3%) side in the diagnostic and RT positions, respectively. In the 19 patients with RPLNMs, the most common level of the caudal edge of the hyoid bone body was at the C4 body in 10 (52.6%) and C3 body in 8 (42.1%) patients in the diagnostic and RT positions, respectively. Conclusions RPLNMs above the hard palate and below the C2/3 disk level extremely rarely develop in patients with HPC. The cranial edge level of the hyoid bone varied significantly among treatment positions. Regardless of the treatment position, the cranial and caudal borders of the RPLN for ENI should be defined as the hard palate and cranial edge of C3, respectively.https://doi.org/10.1186/s13014-025-02651-6Head and neck cancerRadiotherapyHypopharyngeal carcinomaLymph node metastasisRetropharyngeal lymph nodeElective nodal irradiation |
| spellingShingle | Satomi Yoshimi Ryo Toya Mika Nakatake Yoshiyuki Fukugawa Hideki Ishimaru Reiko Ideguchi Hirofumi Koike Yutaro Tasaki Shinya Shiraishi Yorihisa Orita Toshinori Hirai Natsuo Oya Craniocaudal spread patterns of retropharyngeal lymph node metastasis in patients with hypopharyngeal carcinoma Radiation Oncology Head and neck cancer Radiotherapy Hypopharyngeal carcinoma Lymph node metastasis Retropharyngeal lymph node Elective nodal irradiation |
| title | Craniocaudal spread patterns of retropharyngeal lymph node metastasis in patients with hypopharyngeal carcinoma |
| title_full | Craniocaudal spread patterns of retropharyngeal lymph node metastasis in patients with hypopharyngeal carcinoma |
| title_fullStr | Craniocaudal spread patterns of retropharyngeal lymph node metastasis in patients with hypopharyngeal carcinoma |
| title_full_unstemmed | Craniocaudal spread patterns of retropharyngeal lymph node metastasis in patients with hypopharyngeal carcinoma |
| title_short | Craniocaudal spread patterns of retropharyngeal lymph node metastasis in patients with hypopharyngeal carcinoma |
| title_sort | craniocaudal spread patterns of retropharyngeal lymph node metastasis in patients with hypopharyngeal carcinoma |
| topic | Head and neck cancer Radiotherapy Hypopharyngeal carcinoma Lymph node metastasis Retropharyngeal lymph node Elective nodal irradiation |
| url | https://doi.org/10.1186/s13014-025-02651-6 |
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