Image-guided intensity modulated radiotherapy with helical tomotherapy for postoperative treatment of high-risk oral cavity cancer

Hsieh, Chen‐Hsi; Kuo, Ying-Shiung; Liao, Li‐Jen; Hu, Kawang-Yu; Lin, Shih-Chiang; Wu, Lianghong; Lin, Yi-Chien; Chen, Yu-Jen; Wang, Liying; Hsieh, Yen‐Ping; Lin, Shoei Long; Chen, Chun-Yi; Chen, Chien-An; Shueng, Pei‐Wei

doi:10.1186/1471-2407-11-37

Cited by 20 publications

(18 citation statements)

References 27 publications

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“…In our previous report, HT provided encouraging clinical results for acute xerostomia 8. Additionally, Hsiung et al11 and Chen et al12 confirmed that radiation-induced trismus progressed over time and was improved by IMRT.…”

Section: Introductionmentioning

confidence: 74%

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Clinical effectiveness, toxicity, and failure patterns of helical tomotherapy for postoperative oral cavity cancer patients

Hsieh¹,

Shueng²,

Wang³

et al. 2014

OTT

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BackgroundThe outcome of postoperative high- and intermediate-risk oral cavity cancer (OCC) patients receiving helical tomotherapy (HT) remains limited.Materials and methodsBetween November 2006 and November 2012, 53 postoperative high- and intermediate-risk OCC patients treated with HT were enrolled.ResultsThe 4-year locoregional, local, and regional control rates were 66%, 76.4%, and 94.3%, respectively. The 4-year locoregional control rates of oral tongue and buccal mucosa cancer were 88.3% and 37.1%, respectively (P=0.012). Eleven (20.8%) patients experienced locoregional failure. In-field failure occurred in six of 53 (11.3%) in the primary area and three of 53 (5.7%) in the regional lymph-node area. No marginal failure was noted. Two of 53 (3.8%) experienced out-of-field failure. The rates of grade 3 dermatitis, mucositis, and dysphagia were 11%, 34%, and 13%, respectively. No grade 3 xerostomia was noted. Grade 2 xerostomia was 33% at month 6 and declined to 0 at month 48. A rate of 56% of grade 2 trismus at month 6 was noted, and declined to around 30% after 2 years. No grade 3 trismus was noted after 2 years.ConclusionHT as a postoperative modality provided satisfying results, especially for xerostomia and trismus, and was impressive in high- and intermediate-risk OCC patients receiving postoperative HT.

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Section: Introductionmentioning

confidence: 74%

“…HT with daily fractions of 1.8 or 2 Gy on 5 consecutive days was prescribed. The frame, fusing, and planning system were applied as per a previous report 8. CT scans with 3 mm slice thickness were done for treatment planning.…”

Section: Methodsmentioning

confidence: 99%

Clinical effectiveness, toxicity, and failure patterns of helical tomotherapy for postoperative oral cavity cancer patients

Hsieh¹,

Shueng²,

Wang³

et al. 2014

OTT

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“…The patient sample size regarding HT for pleural mesothelioma was very small, resulting in considerable bias in the results (Table ). xi Oral cancer: the results of 4 observational studies and 1 CCT ( n = 145) involving oral tumors showed that, after treatment with HT in combination with chemotherapy, there was frequent severe mucosal toxicity and blood toxicity; toxicity associated with the use of HT alone was low. The 2‐year survival rate, local control rate, and non‐transfer rate of HT for oral cancer were all >90%, but those for oropharyngeal cancer were lower.…”

Section: Resultsmentioning

confidence: 99%

Helical tomotherapy for cancer treatment: a rapid health technology assessment

Yang

Shen

et al. 2014

J Evidence Based Medicine

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The evidence of this study showed that, HT is safe and effective in clinic. But the abovementioned conclusion needs to be verified by conducting more high-quality studies with long-term follow-up. The costs of HT in procurement, maintenance, and application are high; and the skills, training, and qualification of operators are required. We suggest that the procurement of HT should be reduced; it should be allocated rationally and effectively used after comprehensive assessment in China's cancer epidemiology characteristics, health resource allocation, disease burden, medical service level, etc.; and also high-quality studies with long-term follow-up should be financially supported on the basis of establishing projects, so as to provide local evidence and consistently guide and improve scientific decision-making.

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“…Excellent loco-regional control and survival have been achieved for various anatomic head and neck cancer sites. In a study of 19 patients with locally advanced oral cavity cancer who received postoperative irradiation with IGRT, the 2-year survival and loco-regional control were 94 and 92%, respectively (33). In another study of 28 patients who underwent concurrent chemotherapy and IGRT for locally advanced nasopharyngeal cancer, the 3-year survival and loco-regional control were respectively 83.5 and 88.4% respectively (34).…”

Section: Effectiveness Of Igrt For Loco-regional Control In Patientsmentioning

confidence: 99%

Image-guided radiotherapy for locally advanced head and neck cancer

Nguyen¹,

Kratz

Lemanski

et al. 2013

Front. Oncol.

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Treatment of locally advanced head and neck cancer remains a challenge because of the head and neck complex anatomy and the tumor invasion to the adjacent organs and/or metastases to the cervical nodes. Postoperative irradiation or concurrent chemoradiation may lead to damage of radiosensitive structures such as the salivary glands, mandible, cochlea, larynx, and pharyngeal muscles. Xerostomia, osteoradionecrosis, deafness, hoarseness of the voice, dysphagia, and aspiration remain serious complications of head and neck irradiation and impair patient quality of life. Intensity-modulated and image-guided radiotherapy by virtue of steep dose gradient and daily imaging may allow for decreased radiation of the organs at risk for complication while preserving loco-regional control.

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Image-guided intensity modulated radiotherapy with helical tomotherapy for postoperative treatment of high-risk oral cavity cancer

Cited by 20 publications

References 27 publications

Clinical effectiveness, toxicity, and failure patterns of helical tomotherapy for postoperative oral cavity cancer patients

Clinical effectiveness, toxicity, and failure patterns of helical tomotherapy for postoperative oral cavity cancer patients

Helical tomotherapy for cancer treatment: a rapid health technology assessment

Image-guided radiotherapy for locally advanced head and neck cancer

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