Outcomes of Postoperative Simultaneous Modulated Accelerated Radiotherapy for Head-and-Neck Squamous Cell Carcinoma

Moon, Sung Ho; Jung, Yuh‐Seog; Ryu, Junsun; Choi, Sung Rak; Park, Joo Yong; Yun, Tak; Lee, Sang Hyun; Cho, Kwan Ho

doi:10.1016/j.ijrobp.2010.04.068

Cited by 14 publications

(12 citation statements)

References 28 publications

(51 reference statements)

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“…Preliminary results are comparable with those obtained with segmental MLC-based IMRT in terms of tumour control with a locoregional control and an overall survival of 75-80% and 66-82%, respectively, at 2 years [8][9][10][11][12]. Only one published clinical study showed the ability of TOMO to spare the parotid gland and preserve the salivary function [44].…”

Section: Helical Tomotherapysupporting

confidence: 52%

New techniques in radiation therapy for head and neck cancer

Thariat

Bolle²,

Demizu³

et al. 2011

Anti-Cancer Drugs

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The objective of this study was to assess the comparative effectiveness of intensity-modulated radiation therapy (IMRT), conformal and two-dimensional radiation therapy, proton beam, and carbon ion therapy in terms of tumor control and survival on the one hand and adverse events and quality of life on the other in irradiated head and neck cancer patients. A search of the literature was performed. At a given time, innovative techniques in radiation therapy may appear superior to routine irradiation techniques and clinical trials may therefore be considered unethical. IMRT, because of its superiority in terms of dose distributions and potential to preserve the salivary glands, has gradually replaced two-dimensional and conformal irradiation in routine use. The PARSPORT phase III trial is one among the rare trials to randomize two-dimensional and conformal irradiation against IMRT. It showed a 50% reduction in late xerostomia. Similarly, the relevance of clinical trials to prove the superiority of protons compared with photons is highly controversial. Although the expected benefit of particle beam therapy on dose distributions, local control, and quality of life seems sufficient for routine use without phase III trials, it should be noted that new toxicity profiles might be seen as was the case for IMRT (posterior alopecia, anterior mucositis, uncertainties of integral dose, and secondary cancers). Prospective clinical and medico-economic assessment, possibly in phase II trials, is therefore critically needed along with stringent quality assurance programs. Technological advances in radiation therapy clearly provide a benefit for patients despite the lack of level I evidence.

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Section: Helical Tomotherapysupporting

confidence: 52%

New techniques in radiation therapy for head and neck cancer

Thariat

Bolle²,

Demizu³

et al. 2011

Anti-Cancer Drugs

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“…12 Volumetricmodulated arc therapy, a form of rotational IMRT, and stereotactic RT, a form of highly focused irradiation using tridimensional tumor targeting, also offer advantages. 13 Arc therapy reduces IMRT delivery time from 20 minutes to fewer than 5 minutes, while optimizing dose homogeneity and normal tissue sparing, [14][15][16][17][18][19][20][21][22][23][24][25] including parotid gland sparing. 26 Stereotactic fractionated RT allows for the generation of x-ray beams from a single electronic source, which can be rotated or moved around a central focus.…”

Section: Chemoradiation Therapymentioning

confidence: 99%

Oral complications of cancer and cancer therapy

Epstein

Thariat

Bensadoun

et al. 2012

CA A Cancer J Clinicians

429

356

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Answer questions and earn CME/CNEOral complications resulting from cancer and cancer therapies cause acute and late toxicities that may be underreported, underrecognized, and undertreated. Recent advances in cancer treatment have led to changes in the incidence, nature, and severity of oral complications. As the number of survivors increases, it is becoming increasingly recognized that the aggressive management of oral toxicities is needed to ensure optimal long‐term oral health and general well‐being. Advances in care have had an impact on previously recognized oral complications and are leading to newly recognized adverse effects. Here, the authors briefly review advances in cancer therapy, including recent advances in surgery, oral care, radiation therapy, hematopoietic cell transplantation, and medical oncology; describe how these advances affect oral health; and discuss the frequent and/or severe oral health complications associated with cancer and cancer treatment and their effect upon long‐term health. Although some of the acute oral toxicities of cancer therapies may be reduced, they remain essentially unavoidable. The significant impact of long‐term complications requires increased awareness and recognition to promote prevention and appropriate intervention. It is therefore important for the primary oncologist to be aware of these complications so that appropriate measures can be implemented in a timely manner. Prevention and management is best provided via multidisciplinary health care teams, which must be integrated and communicate effectively in order to provide the best patient care in a coordinated manner at the appropriate time. CA Cancer J Clin 2012. © 2012 American Cancer Society.

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“…Nevertheless, for acute toxicities, no grade 3 xerostomia or body-weight loss was noted. Grade 3 dermatitis and dysphagia occurred with postoperative IMRT concurrent with chemotherapy at a rate of 7%–10% and 24%–83%, respectively 18–20. However, the rates of grade 3 dermatitis and dysphagia for patients treated with adjuvant HT were 11% and 13%, respectively.…”

Section: Discussionmentioning

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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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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Outcomes of Postoperative Simultaneous Modulated Accelerated Radiotherapy for Head-and-Neck Squamous Cell Carcinoma

Cited by 14 publications

References 28 publications

New techniques in radiation therapy for head and neck cancer

New techniques in radiation therapy for head and neck cancer

Oral complications of cancer and cancer therapy

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

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