Exploring the current problem of target delineation based on the characteristics of axillary lymph node metastasis in nasopharyngeal carcinoma

Abstract Patients with axillary lymph node metastasis after radical radiotherapy for nasopharyngeal carcinoma are clinically visible, and the reasons for this condition are unclear. We conducted a retrospective study on a small sample to explore the characteristics of metastasis. We reviewed all nasopharyngeal carcinoma patients admitted to our department from 2015 to 2020 and selected 6 patients who developed axillary lymph node metastasis after treatment. These 6 patients all belonged to the N3 stage before treatment, and lymph node metastasis occurred in the axillary area on the same or more severely affected side of the supraclavicular lymph node metastasis. From the occurrence time of axillary lymph node metastasis, the closer the cervical lymph node metastasis to the subclavian region, the earlier and more extensive the axillary lymph node metastasis is. In summary, for patients with supraclavicular lymph node metastasis before treatment, there is a risk of axillary lymph node metastasis after treatment. For patients with supraclavicular lymph node metastasis that is lower or closer to the subclavian area, it is necessary to receive prophylactic radiotherapy in the ipsilateral axillary area during radiotherapy.