Comparison of survival rates between patients treated with conventional radiotherapy and helical tomotherapy for head and neck cancer

Kong, Moonkyoo; Hong, Seong Eon; Choi, Ji Sun; Kim, Youngkyong

doi:10.3857/roj.2013.31.1.1

Cited by 18 publications

(20 citation statements)

References 30 publications

(46 reference statements)

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“…For radiation therapy of H&N cancer, it is important to get accurate CT images for target delineation and dose calculation because of the concave-shaped target volumes, the complex anatomy and the relative abundance of sensitive normal tissues close to the target. 29,30 This study evaluated the effectiveness of the OMAR function in correcting for the metal artefacts induced by dental implants in closed-and opened-mouth H&N patients. Moreover, the dosimetric effect was investigated by type of dental implant using a in-house custom-built phantom.…”

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confidence: 99%

Evaluation of a commercial orthopaedic metal artefact reduction tool in radiation therapy of patients with head and neck cancer

Kwon

Kim

Chun³

et al. 2015

BJR

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Objective: To assess the image quality and dosimetric effects of the Philips orthopaedic metal artefact reduction (OMAR) (Philips Healthcare System, Cleveland, OH) function for reducing metal artefacts on CT images of head and neck (H&N) patients. Methods: 11 patients and a custom-built phantom with metal bead inserts (alumina, titanium, zirconia and chrome) were scanned. The image was reconstructed in two ways: with and without OMAR (OMAR and non-OMAR image). The mean and standard deviation values of CT Hounsfield unit (HU) for selected regions of interest of each case were investigated for both images. Volumetric modulated arc therapy plans were generated for all cases. Gamma analysis of each dose distribution pair in the patient (1%/1 mm criteria) and phantom (2%/2 mm and 3%/3 mm criteria) images was performed. The film measurements in phantom for two metal beads were conducted for evaluating the calculated dose on both OMAR and non-OMAR images.Results: In the OMAR images, noise values were generally reduced, and the mean HU became closer to the reference value (measured from patients without metal implants) in both patient and phantom cases. Although dosimetric difference was insignificant for the eight closed-mouth patients (g 5 99.4 60.5%), there was a large discrepancy in dosimetric calculation between OMAR and non-OMAR images for the three opened-mouth patients (g 5 91.1%, 94.8% and 96.6%). Moreover, the calculated dose on the OMAR image is closer to the real delivered dose on a radiochromic film than was the dose from the non-OMAR image. Conclusion: The OMAR algorithm increases the accuracy of CT HU and reduces the noise such that the entire radiation treatment planning process can be improved, especially for contouring and segmentation. Advances in knowledge: OMAR reconstruction is appropriate for the radiotherapy planning process of H&N patients, particularly of patients who use a bite block.Over the duration of several surgeries and treatments, metallic objects such as orthopaedic implants, surgical staples and clips, radioisotope seeds or dental implants may be inserted into the patient's body. Owing to the high Z of these materials, metal streak artefacts in the CT image can be induced through the combination of beam hardening, scatter, photon starvation, partial volume effects and aliasing.

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confidence: 99%

Evaluation of a commercial orthopaedic metal artefact reduction tool in radiation therapy of patients with head and neck cancer

Kwon

Kim

Chun³

et al. 2015

BJR

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“…Currently, using modern imaging and radiation techniques (IMRT, image-guided radiation therapy (IGRT) and adaptive RT) in combination with CTX is mandatory to enhance the therapeutic ratio and to improve outcomes [7,42,43,44]. Vlacich et al [9] compared the outcome of patients treated with sequential boost and integrated boost using IMRT concurrent to CTX for locally advanced head and neck cancer.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Carboplatin/Paclitaxel-Based Radiochemotherapy in Locally Advanced Squamous Cell Carcinoma of Head and Neck

et al. 2018

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Background: Cisplatin-based chemotherapy (CTX) is commonly used concurrently with radiotherapy for head and neck cancer. The value of CTX regimens other than cisplatin for locally advanced squamous cell carcinoma of head and neck (LASCCHN) has not been well established. Here we compare the outcome of patients treated with different platinum-based chemotherapy regimens. Methods: Medical records from 104 patients with LASCCHN treated with radiochemotherapy (RCTX) between February 2013 and August 2016 were analyzed. Results: All patients were treated with intensity-modulated radiation therapy (51 definitive, 53 postoperative). The median total dose was 66.6 Gy and the median fraction dose was 1.8 Gy. 81 (78%) patients were administered cisplatin CTX, 23 (22%) patients received carboplatin and paclitaxel (CarboTaxol). The rate of recurrence was 38% in patients treated with cisplatin and 30% in CarboTaxol-treated patients (p = 0.6). Regarding the CTX regimens, event-free survival (EFS) was 37 versus 30 months (p = 0.6) and overall survival (OS) was 35 versus 28 months (p = 0.5) in cisplatin group versus CarboTaxol group, respectively. Significantly higher grade 3/4 acute toxicity in terms of dysphagia was observed following cisplatin-based RCTX (p = 0.002). In multivariable analysis, females and patients with early primary tumors (T1-2) have longer EFS and OS, regardless the CTX regimen. Conclusions: Primary or adjuvant RCXT with CarboTaxol is a safe and effective treatment alternative for LASCCHN patients with contraindication to cisplatin-based RCTX.

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“…Unlike other head and neck cancers (18), the application of IMRT (including VMAT) is not generalized in early-stage glottic cancer. Conventional RT delivered with lateral opposed beams is more commonly used for early-stage glottic cancer due to the small RT field and the lack of requirement for elective cervical node irradiation (17).…”

Section: Discussionmentioning

confidence: 99%

Volumetric modulated arc radiotherapy of the whole larynx, followed by a single affected vocal cord, for T1a glottic cancer: Dosimetric analysis of a case

Yeo

2016

Molecular and Clinical Oncology

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Abstract. Radiation therapy (RT) and endolaryngeal surgery are standard treatments for early-stage glottic cancer. They have closely matched oncological outcomes; however, it is debatable which method is superior in terms of functional outcomes. Several dosimetric studies have demonstrated that, compared with conventional RT, intensity-modulated RT (IMRT) reduces unnecessary radiation of the adjacent normal tissues, including the carotid artery and thyroid gland. However, RT targets the whole larynx, whereas endolaryngeal surgery is a highly focused treatment involving the en bloc resection of a tumor with safety margins. For T1a glottic cancer, in which the tumor is limited to one vocal cord, the technical feasibility of targeting IMRT on the single vocal cord affected has been investigated; however, the clinical feasibility and the possibility of inferior local control remain to be elucidated. In the present case study, IMRT was used to treat the whole larynx first, and then to treat a single vocal cord. The patient in the present study had T1a glottic cancer, and received volumetric modulated arc therapy with a total dose of 63 Gy/28 fractions. The first treatment phase (40.5 Gy/18 fractions) targeted the whole larynx to eliminate subclinical disease. The second treatment phase (22.5 Gy/10 fractions) targeted only the involved vocal cord. During this treatment phase, the exposure of the non-involved right vocal cord, the right carotid artery and the thyroid gland to the radiation was lower compared with the continuation of the initial treatment approach. These findings suggested that changing the target volume from the whole larynx to the affected vocal cord during the course of IMRT is feasible for T1a glottic cancer, and that it may reduce functional side effects while maintaining oncological outcomes.

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Comparison of survival rates between patients treated with conventional radiotherapy and helical tomotherapy for head and neck cancer

Cited by 18 publications

References 30 publications

Evaluation of a commercial orthopaedic metal artefact reduction tool in radiation therapy of patients with head and neck cancer

Evaluation of a commercial orthopaedic metal artefact reduction tool in radiation therapy of patients with head and neck cancer

Efficacy of Carboplatin/Paclitaxel-Based Radiochemotherapy in Locally Advanced Squamous Cell Carcinoma of Head and Neck

Volumetric modulated arc radiotherapy of the whole larynx, followed by a single affected vocal cord, for T1a glottic cancer: Dosimetric analysis of a case

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