Clinical outcome and toxicity after simultaneous integrated boost IMRT in head and neck squamous cell cancer patients

Dragan, Tatiana; Beauvois, Sylvie; Moreau, Michel; Paesmans, Marianne; Vandekerkhove, C.; Cordier, Lionel; Gestel, Dirk Van

doi:10.1016/j.oraloncology.2019.09.012

Cited by 18 publications

(18 citation statements)

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“…Ghi et al (21) compared ICT followed by CCRT and CCRT alone, with conventional fractionated radiotherapy (2 Gy/F), and the rates of grade 3-4 mucositis and dermatitis were 34.5 and 14%, respectively, with no significant difference observed in the acute toxicity during CCRT between ICT and non-ICT use. Dragan et al (22) retrospectively analyzed simultaneous integrated boost IMRT in patients with headand-neck squamous cell carcinoma, with a high-risk PTV dose of 2-2.2 Gy/F for the postoperatively group and 2 Gy/F for the definitive irradiated group. Acute grade 3 toxicities were dysphagia (44%), oral and/or oropharyngeal mucositis (40%), and dermatitis (21%), which were higher than those in our study.…”

Section: Discussionmentioning

confidence: 99%

Induction Chemotherapy Plus Simultaneous Modulated Accelerated Radiation Therapy in Non-operative Hypopharyngeal and Supraglottic Laryngeal Squamous Cell Carcinoma: Long-Term Outcome of a Prospective Phase 2 Study

Cai

et al. 2021

Front. Oncol.

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Background: To evaluate the toxicities and long-term outcomes of induction chemotherapy (ICT) plus simultaneous modulated accelerated radiation therapy (SMART) in non-operative hypopharyngeal and supraglottic laryngeal squamous cell carcinoma (SCCH/L).Materials and Methods: This was a prospective phase 2 study. Patients diagnosed with SCCH/L, aged from 18 to 75, staged from III to IVB in accordance with the AJCC 2010 criteria, and refusing surgery were eligible. The patients were treated with 2–3 cycles of docetaxel-cisplatin-based ICT and SMART combined with 2–3 cycles of cisplatin-based concurrent chemotherapy. The prescription dose to the primary tumor and metastatic nodes was 69 Gy in 30 fractions. Acute and late toxicities were assessed according to the established Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer (RTOG/EORTC) criteria, and long-term outcomes were analyzed.Results: Between February 2013 and June 2015, 55 newly diagnosed SCCH/L patients were enrolled. No grade 2 or worse acute xerostomia was noted. The incidences of grade 3 acute dermatitis, oral mucositis, and pharyngoesophagitis were 12.7, 3.6, and 12.7%, respectively. The median follow-up time was 48 months (range 5.5–74 months). The main late toxicity was hoarseness or sore throat, with an incidence of 32.7%. The 5-year functional larynx-preservation survival was 51.5%. The 3- and 5-year locoregional control and overall survival were 58.2, 51.5, 63.6, and 54.1%, respectively.Conclusions: The ICT plus SMART with a regimen of 69 Gy/30 F for the treatment of SCCH/L demonstrated acceptable severe toxicity, satisfactory long-term outcomes, and laryngeal function preservation.

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Section: Discussionmentioning

confidence: 99%

Induction Chemotherapy Plus Simultaneous Modulated Accelerated Radiation Therapy in Non-operative Hypopharyngeal and Supraglottic Laryngeal Squamous Cell Carcinoma: Long-Term Outcome of a Prospective Phase 2 Study

Cai

et al. 2021

Front. Oncol.

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“…In one study, there was a trend towards chemotherapy leading to worse taste outcomes [24]. However, on the whole, chemotherapy was mostly found to have no statistically significant impact on taste dysfunction [15][16]22,37,39,45].…”

Section: Other Risk/modifying Factorsmentioning

confidence: 99%

“…In later decades, studies started using the European Organisation for Research and Treatment of Cancer Head and Neck Questionnaire (EORTC-HNQ) [22][23][24] which assesses a range of toxicities following treatment for HNC, including sense of smell and taste [25]. The University of Washington Quality of Life (UWQOL) questionnaire is a similar tool and was used by Sapir et al for their study in 2016 [26].…”

Section: Subjective Measuresmentioning

confidence: 99%

“…Subjective acute dysfunction prevalence ranged from 51-100% of patients [18,22,24,[27][28][31][32][38][39], while that of objective acute dysfunction ranged from 52-100% [22,26,[32][33]37,[40][41]. The only two studies that showed substantially lower rates of acute dysfunction either used a customised bite block (0% acute taste loss) [30] or used PBT (5.6% acute taste loss) [31].…”

Section: Onset and Prevalence Of Acute Taste Dysfunction In Patients Undergoing Radiotherapymentioning

confidence: 99%

“…In these studies, while prevalence of dysfunction again ranged considerably, there was clearly some evidence of late toxicity [7,14,[23][24][44][45]. At 2-3 years, the prevalence of subjective taste dysfunction was 23-53% [14,[23][24]. Other studies included patients with such a wide range of time since RT (e.g.…”

Section: Recovery and Prevalence Of Late Effectsmentioning

confidence: 99%

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Taste dysfunction following radiotherapy to the head and neck: A systematic review

Gunn

Gilbert²,

Nenclares

et al. 2021

Radiotherapy and Oncology

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Background: An intact sense of taste provides pleasure, supports sustenance and alerts the body to toxins. Head and neck cancer (HNC) patients who receive radiotherapy (RT) are high-risk for developing radiation-induced taste dysfunction. Advances in RT offer opportunities for taste-preserving strategies by reducing dose to the gustatory organs-at-risk. Methods: PubMed, Medline and EMBASE were searched for publications reporting on taste, RT and HNC. Randomised trials, cohort studies and cross-sectional studies were included. Results: 31 studies were included in this review. Meta-analysed prevalence of acute taste dysfunction following RT was approximately 96% (95% CI 64 to 100%) by objective measures and 79% (95% CI 65 to 88%) by subjective measures, with the majority of patients showing at least partial recovery. Long-term dysfunction was seen in~25% of patients. Taste dysfunction was associated with sequalae including weight loss and reduced quality-of-life (QoL). Taste dysfunction was more common when the oral cavity, and specifically the anterior two-thirds of the tongue, was irradiated, suggesting a dose constraint for taste preservation might be feasible. Proton beam therapy and customised bite blocks reduced dose to the gustatory field and subsequent loss of taste. Conclusions: Taste dysfunction following RT is common and negatively affects patients' nutritional status and QoL. Decisions about treatment strategies, including choice of RT modality, dose distribution across the gustatory field and the use of adjuncts like bite blocks may be beneficial. However, evidence is limited. There is a pressing need for randomised studies or large prospective cohort studies with sufficient adjustment for confounders.

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Ion therapy guideline (Version 2020)

Zhang

Kong²,

Liu

et al. 2021

Precision Radiation Oncology

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National Laboratory launched proton therapy.After experimentation with different kinds of particles, including neutrons, mesons, helium ions, and neon ions, the National Institute of Radiological Sciences in Japan started using carbon ions for cancer treatment. Proton therapy has the physical advantage of the Bragg peak, which can well realize the high-dose distribution in the tumor target volume and the low-dose distribution in surrounding normal tissue, so proton therapy has found wide applications in the field of ion radiotherapy. Nevertheless, the physical dose distribution and biological characteristics of carbon ions are significantly superior to those of other particles. Compared with the conventional photon radiotherapy, carbon ion radiotherapy stands out with its favorable radiophysical and biological advantages. 1 In the current clinical practice, heavy ion radiotherapy mainly refers to the carbon ion radiotherapy.So far, although some textbooks and publications have provided references for standardized applications of ion radiotherapy, there has not yet been any consensus to guide clinical practices. With the rapid development of ion radiotherapy in China, and the increase of proton and heavy ion therapy centers, ion radiotherapy, which serves as a promising radiotherapy technology, has been applicable to more and more indications. Nevertheless, there has not yet been a guideline to guide ion therapy clinical practices based on national circumstancesThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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Clinical outcome and toxicity after simultaneous integrated boost IMRT in head and neck squamous cell cancer patients

Cited by 18 publications

References 50 publications

Induction Chemotherapy Plus Simultaneous Modulated Accelerated Radiation Therapy in Non-operative Hypopharyngeal and Supraglottic Laryngeal Squamous Cell Carcinoma: Long-Term Outcome of a Prospective Phase 2 Study

Induction Chemotherapy Plus Simultaneous Modulated Accelerated Radiation Therapy in Non-operative Hypopharyngeal and Supraglottic Laryngeal Squamous Cell Carcinoma: Long-Term Outcome of a Prospective Phase 2 Study

Taste dysfunction following radiotherapy to the head and neck: A systematic review

Ion therapy guideline (Version 2020)

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