Effect of radiotherapy delay in overall treatment time on local control and survival in head and neck cancer: Review of the literature

Ferreira, José Antonio González; Olásolo, J. Jaén; Azinovic, I.; Jeremić, Branislav

doi:10.1016/j.rpor.2015.05.010

Cited by 114 publications

(62 citation statements)

References 77 publications

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“…15 Longer than standard treatment duration has a negative impact on outcomes of radiotherapy for head and neck cancer, with loco-regional control loss of 1.2% per day or 12-14% per week. 30 Hypofractionated protocols are expected to cause more frequent late complications, while accelerated protocol should cause more acute toxicity, contrary to our results shown in Table 4. 13,31,32 In our study 2 out of 3 manifestations of early toxicity graded 2 or more according to the Dische scale were more frequent in the H group while 3 out of 9 late toxicity manifestations occurred more frequently in the A group.…”

Section: Discussioncontrasting

confidence: 95%

Hypofractionated accelerated radiotherapy in T1–3 N0 cancer of the larynx: A prospective cohort study with historical controls

Szutkowski

Kawecki

Jarząbski

et al. 2016

Reports of Practical Oncology & Radiotherapy

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Section: Discussioncontrasting

confidence: 95%

Hypofractionated accelerated radiotherapy in T1–3 N0 cancer of the larynx: A prospective cohort study with historical controls

Szutkowski

Kawecki

Jarząbski

et al. 2016

Reports of Practical Oncology & Radiotherapy

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“…In combination, although these effects are independent of a facility change in our multivariate analysis, they suggest an area that could be addressed to potentially improve patient outcomes because several studies have demonstrated worsened disease control with prolongation of the treatment course . Estimates demonstrate that each day of delay in radiation leads to a 0.7% to 1% drop in local control . Most important is that this factor may be the most easily modifiable, in that by minimizing treatment breaks, providers at LVRFs may be able to improve outcomes.…”

Section: Discussionmentioning

confidence: 85%

Radiation therapy treatment facility and overall survival in the adjuvant setting for locally advanced head and neck squamous cell carcinoma

Lee

Kelly

et al. 2019

Cancer

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Background Treatment at high‐volume surgical facilities (HVSFs) provides a survival benefit for patients with head and neck squamous cell carcinomas (HNSCCs); however, it is unknown what role postoperative radiation therapy (PORT) plays in achieving the improved outcomes. Methods From the National Cancer Database, 6844 patients with locally advanced invasive HNSCCs of the oral cavity, oropharynx, larynx, and hypopharynx who underwent definitive surgery with PORT between 2004 and 2013 were identified. HVSFs were those in the top percentile for annual case volume during this period. Results The median follow‐up was 54 months. Compared with a lower volume surgical facility (LVSF), an HVSF improved 5‐year overall survival (OS; 57.7% at HVSFs vs 52.5% at LVSFs; P = .0003). Overall, 31.6% of the patients changed their radiation therapy (RT) facility after surgery, with this being more common at HVSFs (39.1% vs 28.9% at LVSFs; P < .001). Among those patients undergoing surgery at an HVSF, remaining at the same facility for RT improved 5‐year OS (63.1% vs 49.3% with a facility change; P < .0001). A propensity score–matched cohort of patients treated at HVSFs confirmed the improved 5‐year OS when patients remained at the treating HVSF for RT (59.2% vs 50.7% with a facility change; P = .005). In a multivariate analysis, treatment at an HVSF and remaining there for RT resulted in a reduced hazard of death (hazard ratio, 0.81; 95% confidence interval, 0.69‐0.94; P = .006). Conclusions The survival benefit associated with HVSFs persists only when patients remain at the facility for RT, and this suggests that facility specialization and/or high‐volume PORT may assist in driving the OS improvement.

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“…A number of studies shows overall treatment time (OTT) to be a critical predictor of the clinical outcome in HNC patients with the main explanation being the fast tumor cell repopulation [30,31]. Gonzalez et al reviewed sixty-five articles confirming a large deleterious effect of prolonged OTT on local control and overall survival [32]. In these studies, the authors found that the delays in RT can result in an average loss of loco-regional control (LRC), ranging from as low as 1.2% per day to as high as 12-14% per week.…”

Section: Disease Controlmentioning

confidence: 99%

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

et al. 2019

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Introduction: A simultaneous integrated boost (SIB) intensity modulated radiotherapy (IMRT) in patients with head and neck squamous cell carcinoma (HNSCC) allows to irradiate different target volumes to different dose levels within a single treatment session without increasing the toxicity. Aim: To analyze the outcome and toxicity of patients treated by definitive or postoperative SIB IMRT for HNSCC. Material and methods: 106 patients with HNSCC of the oral cavity (OC), oropharynx (OP), larynx (L) and hypopharynx (HP), consecutively treated at our cancer center between 3/2012 and 3/2014 were retrospectively analyzed. The prescribed SIB IMRT doses were in the postoperative setting (group A) 60-66 Gy and 53 Gy in 30-33 fractions for PTV high risk and PTV elective, respectively; and 70 Gy and 56 Gy in 35 fractions for PTV high risk and PTV elective, respectively when given as primary treatment (group B). Toxicity was consistently graded according to RTOG/EORTC scale. Results: Median follow-up duration was 31 months. Thirty (28%) patients were postoperatively irradiated (group A) and 76 (72%) patients received definitive IMRT (group B). At 3 years, loco-regional control, distant control and overall survival were 78%, 78%, 57% and 64%, 76%, 52% in the postoperative (group A) and the definitive SIB IMRT group (group B), respectively. The observed acute grade 3 toxicities were dysphagia (44%), oral and/or oropharyngeal mucositis (40%) and dermatitis (21%). Late toxicity was predominantly clinically significant xerostomia (42%), dysgeusia (23%) and dysphagia (8%). Conclusion: SIB IMRT is feasible, safe and effective in the treatment of HNSCC patients.

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Effect of radiotherapy delay in overall treatment time on local control and survival in head and neck cancer: Review of the literature

Cited by 114 publications

References 77 publications

Hypofractionated accelerated radiotherapy in T1–3 N0 cancer of the larynx: A prospective cohort study with historical controls

Hypofractionated accelerated radiotherapy in T1–3 N0 cancer of the larynx: A prospective cohort study with historical controls

Radiation therapy treatment facility and overall survival in the adjuvant setting for locally advanced head and neck squamous cell carcinoma

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

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