International journal of radiation oncology, biology, physics, 2012-07, Vol.83 (3), p.986-993
2012
Details
- Autor(en) / Beteiligte
- Titel
- Adaptive Radiotherapy for Head-and-Neck Cancer: Initial Clinical Outcomes From a Prospective Trial
- Ist Teil von
- International journal of radiation oncology, biology, physics, 2012-07, Vol.83 (3), p.986-993
- Ort / Verlag
- New York, NY: Elsevier Inc
- Erscheinungsjahr
- 2012
- Link zum Volltext
- Quelle
- Elsevier ScienceDirect Journals Complete
- Beschreibungen/Notizen
- Purpose To present pilot toxicity and survival outcomes for a prospective trial investigating adaptive radiotherapy (ART) for oropharyngeal squamous cell carcinoma. Methods and Materials A total of 24 patients were enrolled in an institutional review board–approved clinical trial; data for 22 of these patients were analyzed. Daily CT-guided setup and deformable image registration permitted serial mapping of clinical target volumes and avoidance structures for ART planning. Primary site was base of tongue in 15 patients, tonsil in 6 patient, and glossopharyngeal sulcus in 1 patient. Twenty patients (91%) had American Joint Committee on Cancer (AJCC) Stage IV disease. T stage distribution was 2 T1, 12 T2, 3 T3, 5 T4. N stage distribution was 1 N0, 2 N1, 5 N2a, 12 N2b, and 2 N2c. Of the patients, 21 (95%) received systemic therapy. Results With a 31-month median follow-up (range, 13–45 months), there has been no primary site failure and 1 nodal relapse, yielding 100% local and 95% regional disease control at 2 years. Baseline tumor size correlated with absolute volumetric treatment response ( p = 0.018). Parotid volumetric change correlated with duration of feeding tube placement ( p = 0.025). Acute toxicity was comparable to that observed with conventional intensity-modulated radiotherapy (IMRT). Chronic toxicity and functional outcomes beyond 1 year were tabulated. Conclusion This is the first prospective evaluation of morbidity and survival outcomes in patients with locally advanced head-and-neck cancer treated with automated adaptive replanning. ART can provide dosimetric benefit with only one or two mid-treatment replanning events. Our preliminary clinical outcomes document functional recovery and preservation of disease control at 1-year follow-up and beyond.
- Sprache
- Englisch
- Identifikatoren
- ISSN: 0360-3016eISSN: 1879-355XDOI: 10.1016/j.ijrobp.2011.08.017Titel-ID: cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4271827
- Format
- –
- Schlagworte
- Adaptive radiotherapy, Adult, Aged, Biological and medical sciences, Carcinoma, Squamous Cell - diagnostic imaging, Carcinoma, Squamous Cell - pathology, Carcinoma, Squamous Cell - radiotherapy, CARCINOMAS, Clinical trial, CLINICAL TRIALS, DISEASE INCIDENCE, Female, HEAD, Head and neck cancer, Hematology, Oncology and Palliative Medicine, Humans, Image-guided, IMRT, LYMPHATIC SYSTEM, Male, Medical sciences, Middle Aged, NECK, Neoplasm Staging - methods, Organs at Risk - diagnostic imaging, Oropharyngeal Neoplasms - diagnostic imaging, Oropharyngeal Neoplasms - pathology, Oropharyngeal Neoplasms - radiotherapy, Otorhinolaryngology (head neck, general aspects and miscellaneous), Otorhinolaryngology. Stomatology, PATIENTS, PHARYNX, PLANNING, Prospective Studies, Radiology, RADIOLOGY AND NUCLEAR MEDICINE, RADIOTHERAPY, Radiotherapy Planning, Computer-Assisted - methods, Radiotherapy Setup Errors - prevention & control, Radiotherapy, Image-Guided - adverse effects, Radiotherapy, Image-Guided - methods, Radiotherapy, Intensity-Modulated - adverse effects, Radiotherapy, Intensity-Modulated - methods, Tomography, X-Ray Computed - methods, TONGUE, Tongue Neoplasms - diagnostic imaging, Tongue Neoplasms - pathology, Tongue Neoplasms - radiotherapy, Tonsillar Neoplasms - diagnostic imaging, Tonsillar Neoplasms - pathology, Tonsillar Neoplasms - radiotherapy, TOXICITY, Tumor Burden, Tumors