Analysis of CT-verified loco-regional recurrences after definitive IMRT for HNSCC using site of origin estimation methods

Zukauskaite, Ruta; Hansen, Christian Rønn; Brink, Carsten; Johansen, Jørgen; Asmussen, Jon Thor; Grau, Cai; Overgaard, Jens; Eriksen, Jesper Grau

doi:10.1080/0284186x.2017.1346384

Cited by 27 publications

(21 citation statements)

References 25 publications

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“…In Denmark, a national storage facility of DICOM data has been established [8]. It is currently used by a number of clinical trials [9][10][11][12][13] and contains radiotherapy information from more than 5000 patients. This study focuses on the largest clinical trial in the data bank; a clinical randomized trial on hypo-fractionation from the Danish Breast Cancer Group (DBCG) with 1883 patients, of which 1550 patients were Danish.…”

Section: Introductionmentioning

confidence: 99%

DBCG hypo trial validation of radiotherapy parameters from a national data bank versus manual reporting

et al. 2017

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Section: Introductionmentioning

confidence: 99%

DBCG hypo trial validation of radiotherapy parameters from a national data bank versus manual reporting

et al. 2017

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“…Our findings are consistent with existing literature, reporting locoregional failures to predominantly occur in high-dose volumes for both the older 3D ( 27 ) and more conformal RT techniques ( 28 – 43 ). Compared with previous studies, our analysis provides a larger patient cohort ( 22 , 23 , 27 , 31 , 32 , 39 , 43 ) and longer median follow-up time ( 22 – 24 , 30 – 32 , 35 , 39 ). Leeman et al.…”

Section: Discussionmentioning

confidence: 97%

“…The determination of out-of-field failures, defined as failure that occurred outside the treatment field, is fairly straightforward in published reports. The definition of a marginal failure is, however, not as clear-cut ( 22 , 30 , 31 , 39 ). In the current study, we defined marginal failure as a situation in which at least one-half of the volume of the recurrence appeared to be outside the original tumor site (CTVp or CTVn) ( 39 ).…”

Section: Discussionmentioning

confidence: 99%

Recurrence Patterns After IMRT/VMAT in Head and Neck Cancer

et al. 2021

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PurposeIntensity-modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT), two advanced modes of high-precision radiotherapy (RT), have become standard of care in the treatment of head and neck cancer. The development in RT techniques has markedly increased the complexity of target volume definition and accurate treatment delivery. The aim of this study was to indirectly investigate the quality of current TV delineation and RT delivery by analyzing the patterns of treatment failure for head and neck cancer patients in our high-volume RT center.MethodsBetween 2004 and 2014, 385 patients with pharyngeal, laryngeal, and oral cavity tumors were curatively treated with primary RT (IMRT/VMAT). We retrospectively investigated locoregional recurrences (LRR), distant metastases (DM), and overall survival (OS).ResultsMedian follow-up was 6.4 years (IQR 4.7–8.3 years) during which time 122 patients (31.7%) developed LRR (22.1%) and DM (17.7%). The estimated 2- and 5-year locoregional control was 78.2% (95% CI 73.3, 82.3) and 74.2% (95% CI 69.0, 78.8). One patient developed a local recurrence outside the high-dose volume and five patients developed a regional recurrence outside the high-dose volume. Four patients (1.0%) suffered a recurrence in the electively irradiated neck and two patients had a recurrence outside the electively irradiated neck. No marginal failures were observed. The estimated 2- and 5-year DM-free survival rates were 83.3% (95% CI 78.9, 86.9) and 80.0% (95% CI 75.2, 84.0). The estimated 2- and 5-year OS rates were 73.6% (95% CI 68.9, 77.8) and 52. 6% (95% CI 47.3, 57.6). Median OS was 5.5 years (95% CI 4.5, 6.7).ConclusionTarget volume definition and treatment delivery were performed accurately, as only few recurrences occurred outside the high-dose regions and no marginal failures were observed. Research on dose intensification and identification of high-risk subvolumes might decrease the risk of locoregional relapses. The results of this study may serve as reference data for comparison with future studies, such as dose escalation or proton therapy trials.

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“…The prospective randomized DAHANCA 19 trial investigated the benefit of adding the EGFR-inhibitor zalutumumab to radiotherapy for squamous cell carcinoma of the head and neck (H&N) and enrolled patients from 2007 to 2012 [7] from six radiotherapy treatment centers. The results presented at ESTRO37 showed that zalutumumab did not improve loco-regional tumor control or survival, but resulted in more treatment related toxicity [8][9][10].…”

Section: Patients and Contoursmentioning

confidence: 99%

NTCP model validation method for DAHANCA patient selection of protons versus photons in head and neck cancer radiotherapy

et al. 2019

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Analysis of CT-verified loco-regional recurrences after definitive IMRT for HNSCC using site of origin estimation methods

Abstract: For recurrences identified by possible points of recurrence origin, no significant difference between observer-based or mathematically estimated methods was found. More than half of T-site recurrences were inside high-dose treatment volume, whereas N-site recurrences were mainly outside.

Cited by 27 publications

References 25 publications

DBCG hypo trial validation of radiotherapy parameters from a national data bank versus manual reporting

DBCG hypo trial validation of radiotherapy parameters from a national data bank versus manual reporting

Recurrence Patterns After IMRT/VMAT in Head and Neck Cancer

NTCP model validation method for DAHANCA patient selection of protons versus photons in head and neck cancer radiotherapy

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