Clinical Outcomes of Several IMRT Techniques for Patients With Head and Neck Cancer: A Propensity Score–Weighted Analysis

Bibault, Jean‐Emmanuel; Dussart, Sophie; Pommier, P.; Morelle, Magali; Huguet, Marius; Boisselier, P.; Coche‐Dequeant, B.; Alfonsi, M.; Bardet, É.; Rives, M.; Calugaru, Valentin; Chajon, É.; Noël, G.; Mecellem, Hinda; Vernat, S. Servagi; Perrier, Lionel; Giraud, P.

doi:10.1016/j.ijrobp.2017.06.2456

Cited by 23 publications

(25 citation statements)

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“…Bilateral radiotherapy, especially when combined with radiotherapy to large mucosal areas was reported to provoke high toxicity rates for CCUP patients, but these patients were treated with older 2-or 3-dimensional techniques [33]. Our study focused on patients that were treated with IGRT and IMRT, as these newer techniques have demonstrated superior toxicity profiles for head-and-neck treatments in various analyses [2,22,23,[34][35][36]. Hence, in our cohort, only 5.2% of patients exhibited acute grade 3 radiation dermatitis and 22.4% of patients had acute grade ≥ 3 mucositis with no reported grade 5 toxicities, demonstrating an acceptable tolerance for extended radiotherapy.…”

Section: Discussionmentioning

confidence: 99%

Radiotherapeutic management of cervical lymph node metastases from an unknown primary site – experiences from a large cohort treated with modern radiation techniques

et al. 2020

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Purpose: To analyze management and outcomes following (chemo)radiation therapy in patients with cervical lymph node metastases from an unknown primary site (CCUP) in a large single-center cohort.Methods: Between 2008 and 2019, 58 patients with CCUP were treated with (chemo)radiation therapy at the University of Freiburg Medical Center and were included in this analysis. Overall survival (OS), locoregional progression-free survival (PFS) and distant metastasis-free survival (DMFS) were calculated using the Kaplan-Meier method. The use of diagnostic procedures and their impact on oncological outcomes was analyzed by Cox regression, and treatment-related toxicities were quantified.Results: Median follow-up was 29.9 months (range 4.6-121.9). Twenty-one patients (36.2%) received definitive RT, 35 (60.3%) underwent adjuvant RT, and 2 (3.4%) were treated for oligometastatic disease. Concurrent chemotherapy was prescribed in 40 patients (69.0%). 89.6% of patients completed the prescribed RT, and 65.0% completed the prescribed simultaneous chemotherapy. Locoregional recurrence was observed in 7 patients (12.1%) and distant metastases in 13 cases (22.4%). OS was 81,1, 64.9% and 56,6% after 1, 3 and 5 years, respectively. Univariate analysis of age, gender, extracapsular spread, tumor grading, neck dissection, diagnostic utilization of 18 Ffluorodeoxyglucose positron-emission tomography and concomitant chemotherapy showed no effect on OS (p > 0.05 for all), while smoking was significantly associated with decreased survival (p < 0.05). There was a trend towards impaired OS for patients with advanced nodal status (pN3) (p = 0.07). Three patients (5.2%) experienced grade 3 radiation dermatitis, and 12 (22.4%) developed grade 3 and 1 (1.7%) grade 4 mucositis.(Continued on next page)

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Section: Discussionmentioning

confidence: 99%

Radiotherapeutic management of cervical lymph node metastases from an unknown primary site – experiences from a large cohort treated with modern radiation techniques

et al. 2020

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“…Finally, we focused exclusively on partners of patients in the early stages of treatment, between 1 and 12 months after diagnosis, when later treatment side-effects have not all set in. Radiation therapy in particular is liable to induce later side effects [25]. A more long-term study of disease impact on partners could have been performed.…”

Section: Discussionmentioning

confidence: 99%

Impact of head and neck cancer on partner's sociability

Grandazzi

Roussel

Cuny

et al. 2019

European Annals of Otorhinolaryngology, Head and Neck Diseases

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Introduction"Sociability" is defined as the range of experiences linking the subject to others. This is the first study to focus specifically on the impact of head and neck cancer on the sociability of patients' partners. MethodData were collected via a dedicated questionnaire sent to patients' partners. The main endpoint was partner's self-assessment of the impact of the patient's disease on the partner's everyday life. The impact on sociability was analyzed with respect to: the circle of friends (friendship environment), unknown environment, known outside environment, necessary environment, and solitary activities. ResultsTwo hundred and seventy partners responded. Their everyday activities were impacted by the patient's disease in 71.5% of cases. The friendship environment was badly affected in 46.4% of cases. The unknown environment was affected in 44.0% of cases. Social practices related to the known outside environment were affected in 67.8% of cases, and the necessary environment in 26.0%; the number of solitary activities increased in 35.6% of cases. Social impact on patients' partners was thus considerable.

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“…However, tomotherapy has been mainly used for treatment of breast cancer (341), head and neck tumors (298), prostate carcinoma (285) and sarcoma (262) at our institution. Also tumors of the brain and central nervous system (73), lymphoma (38), anal tumors (37) and gastrointestinal tumors (28) as well as skin (25), lung (22) and bone tumors (12) have been treated.…”

Section: Methodsmentioning

confidence: 99%

“…For head and neck tumors Bibault et al 38,39 found an improved locoregional control and cancer-specific survival for HT treatment compared to volumetric modulated arc irradiation. The requirement of frequent position control when using intensity modulated HT used for treatment of head and neck cancer has been demonstrated 40 .…”

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confidence: 99%

Helical tomotherapy: Comparison of Hi-ART and Radixact clinical patient treatments at the Technical University of Munich

Kraus

Kampfer

Wilkens

et al. 2020

Sci Rep

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The helical tomotherapy (HT) Hi-ART system was installed at our department in April 2007. In July 2018 the first Radixact system in Germany has been launched for clinical use. We present differences, advantages and disadvantages and show future perspectives in patient treatment using two Ht devices. We investigate patient characteristics, image quality, radiotherapy treatment specifications and analyze the time effort for treatments with the Hi-ART system from April 2010 until May 2017 and compare it to the data acquired in the first nine months of usage of the Radixact system. Comparing the Hi-ARt and Radixact system, the unique option of integrated MVct image acquisition has experienced distinct improvement in image quality. Time effort for irradiation treatment could be improved resulting in a mean beam on time for craniospinal axis treatment of 636.2 s for the Radixact system compared to 915.9 s for the Hi-ART system. The beneficial use of tomotherapy for complex target volumes is demonstrated by a head and neck tumor case and craniospinal axis treatment. With the Radixact system MVct image quality has been improved allowing for fast and precise interfraction dose adaptation. The improved time effort for patient treatment could increase the accessibility for clinical usage.

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Clinical Outcomes of Several IMRT Techniques for Patients With Head and Neck Cancer: A Propensity Score–Weighted Analysis

Abstract: TomoTherapy provided better locoregional control and cancer-specific survival than RapidArc treatment, with fewer salivary disorders. No significant difference was shown in progression-free and overall survival. These results should be explored in a randomized trial.

Cited by 23 publications

References 29 publications

Radiotherapeutic management of cervical lymph node metastases from an unknown primary site – experiences from a large cohort treated with modern radiation techniques

Radiotherapeutic management of cervical lymph node metastases from an unknown primary site – experiences from a large cohort treated with modern radiation techniques

Impact of head and neck cancer on partner's sociability

Helical tomotherapy: Comparison of Hi-ART and Radixact clinical patient treatments at the Technical University of Munich

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