Title
Helical tomotherapy in head and neck cancer : a European single-center experienceHelical tomotherapy in head and neck cancer : a European single-center experience
Author
Faculty/Department
Faculty of Medicine and Health Sciences
Research group
Translational Neurosciences (TNW)
Molecular Imaging, Pathology, Radiotherapy & Oncology (MIPRO)
Faculteit Geneeskunde
Publication type
article
Publication
,
Subject
Human medicine
Source (journal)
The oncologist. -
Volume/pages
20(2015):3, p. 279-290
ISSN
1083-7159
ISI
000351919500011
Carrier
E
Target language
English (eng)
Full text (Publishers DOI)
Affiliation
University of Antwerp
Abstract
Background. We report on a retrospective analysis of 147 patients with early and locoregionally advanced squamous cell head and neck cancer (SCCHN) treated with helical tomotherapy (HT). Patients and Methods. Included were patients with SCCHN of theoral cavity (OC), oropharynx (OP), hypopharynx (HP), or larynx (L) consecutively treated in one radiotherapy center in 2008 and 2009. The prescribed HT dose was 60-66 Gy in the postoperative setting (group A) and 66-70 Gy when given as primary treatment (group B). HT was given alone, concurrent with systemic therapy (ST), that is, chemotherapy, biotherapy, or both, and with or without induction therapy (IT). Acute and late toxicities are reported using standard criteria; locoregional failure/progression (LRF), distant metastases (DM), and second primary tumors (SPT) were documented, and event-free survival (EFS) and overall survival (OS) were calculated from the start of HT. Results. Group A patients received HT alone in 22 cases and HT+ST in 20 cases; group B patients received HT alone in 17 cases and HT 1 ST in 88 cases. Severe (grade >= 3) acute mucosal toxicity and swallowing problems increased with more additional ST. After a median follow-up of 44 months, grade >= 2 late toxicity after HT+ST was approximately twice that of HT alone for skin, subcutis, pharynx, and larynx. Forty percent had grade >= 2 late xerostomia, and 29% hadmucosal toxicity. At 3 years, LRF/DM/SPT occurred in 7%/7%/17% and 25%/13%/5% in groups A and B, respectively, leading to a 3-year EFS/OS of 64%/74% and 56%/63% in groups A and B, respectively. Conclusion. The use of HT alone or in combination with ST is feasible and promising and has a low late fatality rate. However, late toxicity is nearly twice as high when ST is added to HT.
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