Target Volume Definition for Intensity-modulated Radiotherapy after Induction Chemotherapy and Patterns of Treatment Failure after Sequential Chemoradiotherapy in Locoregionally Advanced Oropharyngeal Squamous Cell Carcinoma

Loo, Suat; Geropantas, K.; Wilson, Philip; Martin, W.M.C.; Roques, Tom

doi:10.1016/j.clon.2012.07.015

Cited by 19 publications

(13 citation statements)

References 18 publications

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“…Our results add to the body of retrospective data that suggest inferiority of IMRT in terms of survival outcomes is unlikely . Similar to other authors, despite IMRT being a more conformal technique, we did not identify strong evidence in our cases for locoregional recurrences occurring outside defined clinical target volumes.…”

Section: Discussionsupporting

confidence: 79%

Outcomes of intensity‐modulated radiotherapy as primary treatment for oropharyngeal squamous cell carcinoma – a European singleinstitution analysis

Bird

Felice

Michaelidou

et al. 2016

Clinical Otolaryngology

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Section: Discussionsupporting

confidence: 79%

Outcomes of intensity‐modulated radiotherapy as primary treatment for oropharyngeal squamous cell carcinoma – a European singleinstitution analysis

Bird

Felice

Michaelidou

et al. 2016

Clinical Otolaryngology

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“…Although the local control of the whole cohort may appear lower than other recent UK series, unlike other series patients with contraindications to concomitant platinum have been included here (Chan et al, 2011;Loo, Geropantas, Wilson, Martin, & Roques, 2013). For example, within the series by Loo et al, all patients received neoadjuvant TPF chemotherapy (Loo et al, 2013).…”

Section: Discussionmentioning

confidence: 96%

Four Week Hypofractionated Accelerated Intensity Modulated Radiotherapy and Synchronous Carboplatin or Cetuximab in Biologically Staged Oropharyngeal Carcinoma

Benghiat¹,

Sanghera²,

Cashmore³

et al. 2014

CCO

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Hypofractionated accelerated chemoradiotherapy in the conformal era achieved acceptable control rates for squamous cell carcinoma of the head and neck. This study reports outcomes for biologically staged oropharyngeal cancer treated using four-week intensity-modulated radiotherapy (IMRT) and synchronous chemotherapy. Between 2009-2012, patients with squamous cell carcinoma of the oropharynx treated with hypofractionated chemo-IMRT (55Gray in 20 fractions), with either carboplatin or cetuximab were prospectively identified. Outcome measures analysed were 2-year loco-regional recurrence-free survival (LR-RFS) and overall survival (OS). Eighty-five consecutive patients with oropharyngeal cancer (p16 positive never smoked n=17; p16 positive ever smoked n=42; p16 negative n=24; unknown n=2)) were treated with IMRT with carboplatin (n=69) or cetuximab (n=16), with median follow up in surviving patients of 26 months. Two year LR-RFS was 68% for the whole cohort (95% confidence intervals 58%-78%), 87% (58%-97%) for the p16 positive never-smokers, 75% (58%-86%) for the p16 positive ever-smokers and 45% (25%-63%) for the p16 negative patients. OS at 24 months for these groups respectively was 80% (69-87%), 100.0%, 90% (75%-96%) and 46.9% (25%-66%). Factors associated with a worse OS on multivariate analysis were p16 negativity (p<0.001), age>60 (p=0.048), increasing T stage (p=0.021) and contraindication to carboplatin (p<0.001). The acceptable efficacy obtained with this schedule questions the need for synchronous cisplatin in good prognosis groups of oropharyngeal carcinoma. These results may also prompt the examination of a 4 week schedule of chemoradiotherapy in future randomised trials.

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“…A number of single‐institution series have combined moderate acceleration with chemotherapy for advanced HNSCC of multiple subsites with good LRC . These studies had median follow‐up periods ranging from 18 to 42 months and are summarised in Table .…”

Section: Discussionmentioning

confidence: 99%

“…4 A number of single-institution series have combined moderate acceleration with chemotherapy for advanced HNSCC of multiple subsites with good LRC. [10][11][12][13]15,16,18,27 These studies had median follow-up periods ranging from 18 to 42 months and are summarised in Table 4. Heterogeneity in patient and treatment characteristics makes comparisons difficult, but if the analysis is confined to only the series from UCSF, 13 Utah 15 and Chicago 18 comprising patients who received definitive concomitant chemoradiotherapy for stages III-IV head and neck cancer, our control rates and OS are comparable.…”

Section: Discussionmentioning

confidence: 99%

Intensity‐modulated radiotherapy in the treatment of locoregionally advanced head and neck cancer: implementation and outcomes in a New Zealand community hospital

Rumley

Nedev

Sharples

et al. 2016

J of Medical Radiation Sci

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IntroductionIntensity‐modulated radiotherapy (IMRT) has become the standard of care for squamous cell cancer of the head and neck (HNSCC). This report presents early outcomes of IMRT with concomitant chemotherapy in a community setting in New Zealand.MethodsForty‐eight patients with stage III and IV advanced HNSCC received definitive treatment with IMRT. A dose of 66 Gy in 30 fractions was delivered over 6 weeks with 3‐weekly concurrent cisplatin after a single induction cycle of cisplatin and 5‐fluorouracil. Acute toxicity, locoregional control (LRC), disease‐free survival and overall survival (OS) outcomes were analysed.ResultsFollow‐up ranged from 2 to 82 months (median 34 months). Acute grade 2 toxicity was observed in 27 patients and grade 3 toxicity in 19 patients. No patients experienced grade 4 toxicity and there were no treatment‐related deaths. Locoregional failures occurred in six patients and distant metastatic disease occurred in five patients. Actuarial estimates of 3‐year LRC, disease‐free survival and OS were 87.3%, 74.4% and 73.7% respectively.ConclusionDefinitive treatment of stage III and IV cancer of the head and neck with IMRT and concurrent chemotherapy was achievable in the community setting. Acute toxicities were manageable and 3‐year outcomes were comparable to other published series.

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Target Volume Definition for Intensity-modulated Radiotherapy after Induction Chemotherapy and Patterns of Treatment Failure after Sequential Chemoradiotherapy in Locoregionally Advanced Oropharyngeal Squamous Cell Carcinoma

Cited by 19 publications

References 18 publications

Outcomes of intensity‐modulated radiotherapy as primary treatment for oropharyngeal squamous cell carcinoma – a European singleinstitution analysis

Outcomes of intensity‐modulated radiotherapy as primary treatment for oropharyngeal squamous cell carcinoma – a European singleinstitution analysis

Four Week Hypofractionated Accelerated Intensity Modulated Radiotherapy and Synchronous Carboplatin or Cetuximab in Biologically Staged Oropharyngeal Carcinoma

Intensity‐modulated radiotherapy in the treatment of locoregionally advanced head and neck cancer: implementation and outcomes in a New Zealand community hospital

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