Long‐term outcome of ¹⁸F‐fluorodeoxyglucose‐positron emission tomography‐guided dose painting for head and neck cancer: Matched case‐control study

Abstract

Dose-painting strategies can be used to increase dose to specific tumor subvolumes. Five-year local, regional, and distant control rates are comparable with patients treated with conventional IMRT. Volume and intensity of dose escalation should be further tailored, given the possible increase in severe acute and chronic toxicity. Adapting treatment and decreasing dose to the swallowing structures might contribute to lower toxicity rates when applied in smaller tumor volumes. Whether adaptive DPBN can significantly improve outcomes is currently being investigated in a novel clinical trial.

Task Group 174 Report: Utilization of [18F]Fluorodeoxyglucose Positron Emission Tomography ([18F]FDG‐PET) in Radiation Therapy

“…In RT, PET image registration is used for the following purposes among others: (a) better tumor target definition; (b) propagation of contours from one image set to another; (c) adaptive therapy planning/dose painting to selectively increase dose to more PET‐avid target regions; and (d) incorporation of respiratory‐gated PET information in treatment planning . The reader is referred to AAPM Task Group 132 (TG‐132: Use of Image Registration and Fusion Algorithms and Techniques in Radiotherapy), which deals with the topic of image registration in RT.…”

“…(c) adaptive therapy planning/dose painting to selectively increase dose to more PET-avid target regions [94][95][96] ; and (d) incorporation of respiratory-gated PET information in treatment planning. [97][98][99] The reader is referred to AAPM Task Group 132 (TG-132: Use of Image Registration and Fusion Algorithms and Techniques in Radiotherapy), 100 which deals with the topic of image registration in RT.…”

Anal cancer chemoradiotherapy outcome prediction using 18F-fluorodeoxyglucose positron emission tomography and clinicopathological factors

“…Increasing the radiation dose during primary radiotherapy may give a higher local control rate, 42,43 but may also result in unacceptable normal tissue toxicity. Local dose intensification (dose painting) guided by molecular imaging is an organ sparing approach where only the most aggressive part of the tumor is given increased radiation dose and is being explored for squamous cell carcinomas of the head and neck 44,45 and lung. 46 The a priori developed hypothesis that the combination of the size and intensity of the FDG uptake volume combined into the ZMP would be predictive, under the assumption that both the total tumor burden and local hot spots contribute to treatment resistance, was supported in the current work.…”

Robust maximization of tumor control probability for radicality constrained radiotherapy dose painting by numbers of head and neck cancer

“…Dose painting is still under development and has to our knowledge not yet been proved by clinical studies as an outcome-improving treatment technique. For example, Berwouts et al [35] performed a long-term analysis of the outcomes for patients with head and neck cancer that either had been treated with dose painting or conventional IMRT. They found that dose painting increased the risks for toxicities but without significant improvement in outcomes as compared to the control group.…”