Failure patterns of head and neck squamous cell carcinoma treated with radical radiotherapy by intensity modulated radiotherapy technique using focal volume and dosimetric method.
Adult
Aged
Carcinoma, Squamous Cell
/ diagnostic imaging
Chemoradiotherapy
Female
Follow-Up Studies
Head and Neck Neoplasms
/ diagnostic imaging
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Neoplasm Recurrence, Local
Prospective Studies
Radiometry
/ methods
Radiotherapy, Intensity-Modulated
Treatment Failure
Young Adult
failure
head neck
intensity modulated radiotherapy
local control
radiotherapy
Journal
Head & neck
ISSN: 1097-0347
Titre abrégé: Head Neck
Pays: United States
ID NLM: 8902541
Informations de publication
Date de publication:
06 2019
06 2019
Historique:
received:
10
08
2018
revised:
10
09
2018
accepted:
05
12
2018
pubmed:
26
12
2018
medline:
9
9
2020
entrez:
25
12
2018
Statut:
ppublish
Résumé
Labeling locoregional failures in head and neck cancer (HNC) as "local" and "regional" becomes incomplete when treating with intensity modulated radiotherapy (IMRT). Target delineation and delivery errors, dose in-homogeneity complicate the assessment of failures. A combination of focal point and dosimetric method might attempt at simplifying failure analysis. One hundred eleven patients with locally advanced HNC treated with chemoradiation using IMRT were enrolled. Patients with documented failure had their recurrence volume assessed using focal point and dosimetric method. With a median follow-up of 20 (range 0-39) months and median locoregional control (LRC) of 30 (range 24.8-34.5) months, the patients had a 3-year overall survival and LRC of 70.6% and 48.9%, respectively. Of 39 failures, there were 69.2%, 7.6%, 5.1%, 12.8%, and 5.1% type A, B, C, D, and E, respectively using the focal point and dosimetric method. With the current classification, majority of the recurrences were high dose failures suggesting inherent radioresistance. While minority of failures were potentially preventable and needed modifying existing IMRT workflow.
Sections du résumé
BACKGROUND
Labeling locoregional failures in head and neck cancer (HNC) as "local" and "regional" becomes incomplete when treating with intensity modulated radiotherapy (IMRT). Target delineation and delivery errors, dose in-homogeneity complicate the assessment of failures. A combination of focal point and dosimetric method might attempt at simplifying failure analysis.
METHODS
One hundred eleven patients with locally advanced HNC treated with chemoradiation using IMRT were enrolled. Patients with documented failure had their recurrence volume assessed using focal point and dosimetric method.
RESULTS
With a median follow-up of 20 (range 0-39) months and median locoregional control (LRC) of 30 (range 24.8-34.5) months, the patients had a 3-year overall survival and LRC of 70.6% and 48.9%, respectively. Of 39 failures, there were 69.2%, 7.6%, 5.1%, 12.8%, and 5.1% type A, B, C, D, and E, respectively using the focal point and dosimetric method.
CONCLUSION
With the current classification, majority of the recurrences were high dose failures suggesting inherent radioresistance. While minority of failures were potentially preventable and needed modifying existing IMRT workflow.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1632-1637Informations de copyright
© 2018 Wiley Periodicals, Inc.