Chemoradiation in elderly patients with head and neck cancers: a single institution experience

Kataria, Tejinder; Gupta, Deepak; Bisht, Shyam Singh; Goyal, Shikha; Basu, Trinanjan; Srivastava, Abhishek; Agarwal, Abhishek; Hb, Govardhan; Sharma, Kuldeep; Kumar, Vijay

doi:10.1016/j.amjoto.2014.07.015

Cited by 18 publications

(14 citation statements)

References 14 publications

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“…Three studies reported a 2-year overall survival ranging from 73% to 90% [18][19][20]. These results were comparable with those reported in the literature for patients treated without ART [39][40][41]. Indeed, the two studies with a comparison arm did not show a significant difference between the two treatments (ART and no-ART) [19,20].…”

Section: Survival and Loco-regional Controlsupporting

confidence: 77%

“…The 2-year loco-regional control rates (LRCs) for patients treated with ART ranged from 88% to 97% [16,19,20], compared to the 80% rate that was previously reported in the literature [39][40][41]. The 2-year LRC rate was significantly improved for the patients with replanning in comparison to the patients without replanning in two studies (97.2% and 88% for ART compared to 82.2% and 79% for no-ART) [19,20].…”

Section: Survival and Loco-regional Controlmentioning

confidence: 88%

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Adaptive radiotherapy for head and neck cancer

et al. 2018

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Introduction: Large anatomical variations can be observed during the treatment course intensitymodulated radiotherapy (IMRT) for head and neck cancer (HNC), leading to potential dose variations. Adaptive radiotherapy (ART) uses one or several replanning sessions to correct these variations and thus optimize the delivered dose distribution to the daily anatomy of the patient. This review, which is focused on ART in the HNC, aims to identify the various strategies of ART and to estimate the dosimetric and clinical benefits of these strategies. Material and methods: We performed an electronic search of articles published in PubMed/MEDLINE and Science Direct from January 2005 to December 2016. Among a total of 134 articles assessed for eligibility, 29 articles were ultimately retained for the review. Eighteen studies evaluated dosimetric variations without ART, and 11 studies reported the benefits of ART. Results: Eight in silico studies tested a number of replanning sessions, ranging from 1 to 6, aiming primarily to reduce the dose to the parotid glands. The optimal timing for replanning appears to be early during the first two weeks of treatment. Compared to standard IMRT, ART decreases the mean dose to the parotid gland from 0.6 to 6 Gy and the maximum dose to the spinal cord from 0.1 to 4 Gy while improving target coverage and homogeneity in most studies. Only five studies reported the clinical results of ART, and three of those studies included a non-randomized comparison with standard IMRT. These studies suggest a benefit of ART in regard to decreasing xerostomia, increasing quality of life, and increasing local control. Patients with the largest early anatomical and dose variations are the best candidates for ART. Conclusion: ART may decrease toxicity and improve local control for locally advanced HNC. However, randomized trials are necessary to demonstrate the benefit of ART before using the technique in routine practice.

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Section: Survival and Loco-regional Controlsupporting

confidence: 77%

Section: Survival and Loco-regional Controlmentioning

confidence: 88%

Adaptive radiotherapy for head and neck cancer

et al. 2018

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“…A previous publication from our institute on chemoradiation for elderly patients with HNC had shown a 2-year locoregional control of 71.6% and 2-year OS of 88.9%. 17 …”

Section: Discussionmentioning

confidence: 99%

Clinical outcomes of adaptive radiotherapy in head and neck cancers

Kataria¹,

Gupta²,

Goyal³

et al. 2016

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Objective: The present study evaluated the efficacy and toxicity of adaptive radiotherapy (RT) among patients with head and neck cancer. Methods: 36 patients eligible for radical RT underwent RT planning scans and were planned for 54-Gy dose to both high-risk and low-risk target volumes in Phase I. All patients underwent a second (adaptive) scan during the fifth week of RT. Phase II plans for 16 Gy to high-risk planning target volume were developed on these mid-treatment scans. The primary end point was local response. Disease-free survival (DFS), overall survival (OS) and treatment-related morbidity were secondary end points.

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“…According to our search criteria, 2543 papers were initially identified. After sorting and removal of duplicates, 82 papers that fully fit our inclusion criteria were retrieved, reviewed in detail, and summarized in Tables according to the modality of treatment used: RT, systemic therapy (CT or targeted therapy), surgery, or multimodal therapy …”

Section: Introductionmentioning

confidence: 99%

The role of age in treatment‐related adverse events in patients with head and neck cancer: A systematic review

et al. 2019

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Head and neck squamous cell carcinoma (HNSCC) is often diagnosed in advanced stage and therefore requires aggressive, multimodal treatment. Elderly patients are often excluded from standard therapy regimens purely based on age. This clinical review aims to collect all published data in the literature on treatment modality selection in elderly patients and on age-related adverse events following treatment of HNSCC. We performed a literature search for articles on the treatment of HNSCC in elderly patients. Most of the articles were retrospective studies with the consequent limitations. It can be concluded that age is not an absolute contraindication for intensive treatment and comorbidity is an important predictor of outcome, but not the only one. Despite the existence of multiple tools for pretreatment evaluation, there are not consistent data on their use.

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Chemoradiation in elderly patients with head and neck cancers: a single institution experience

Cited by 18 publications

References 14 publications

Adaptive radiotherapy for head and neck cancer

Adaptive radiotherapy for head and neck cancer

Clinical outcomes of adaptive radiotherapy in head and neck cancers

The role of age in treatment‐related adverse events in patients with head and neck cancer: A systematic review

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