Initial clinical experience with helical tomotherapy for head and neck cancer

Chen, Allen M.; Jennelle, R.; Sreeraman, R.; Yang, Christopher; Liu, Tianxiao; Vijayakumar, Srinivasan; Purdy, James A.

doi:10.1002/hed.21123

Cited by 21 publications

(14 citation statements)

References 25 publications

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“…4). This is consistent with other studies on the recurrence sites of head and neck tumors in association with the isodoses on the planning CT (14). Thus, lateral positioning with daily-corrected setup errors did not jeopardize the accurate delivery of the dose to the target volume.…”

Section: Discussionsupporting

confidence: 93%

A novel setup approach for helical tomotherapy in head and neck cancer: A case report

et al. 2013

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Head and neck cancers that are associated with high-risk factors have a poor prognosis. In such patients, post-operative radiochemotherapy is mandatory. The present study describes the case of a 71-year-old high-risk head and neck cancer patient who was not able to tolerate the supine position for the radiotherapy setup. A lateral immobilization with a head mask and a vacuum cushion was performed. The patient underwent daily computed tomography (CT)-guided radiation therapy [image-guided radiation therapy (IGRT)]. At nine months post-radiotherapy, the patient had no xerostomia and no swallowing dysfunction. However, the patient suffered a local recurrence and succumbed due to bleeding of the tumor a number of weeks after the recurrence. A recalculation of the actual delivered dose, taking the daily delivered dose into account, was performed. The recurrence occurred within the high-dose region. In selected cases of patients with head and neck cancers who are unable to tolerate the supine position, lateral positioning and high precision treatment is possible using daily IGRT.

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Section: Discussionsupporting

confidence: 93%

A novel setup approach for helical tomotherapy in head and neck cancer: A case report

et al. 2013

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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: 75%

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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“…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

411

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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Initial clinical experience with helical tomotherapy for head and neck cancer

Abstract: HT appears to achieve clinical outcomes comparable to contemporary series reporting on IMRT for head and neck cancer.

Cited by 21 publications

References 25 publications

A novel setup approach for helical tomotherapy in head and neck cancer: A case report

A novel setup approach for helical tomotherapy in head and neck cancer: A case report

New techniques in radiation therapy for head and neck cancer

Oral complications of cancer and cancer therapy

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