Patterns-of-failure after helical tomotherapy-based chemoradiotherapy for head and neck cancer: Implications for CTV margin, elective nodal dose and bilateral parotid sparing

Primary tumor delineation based on 18FDG PET for locally advanced head and neck cancer treated by chemo-radiotherapy

“…Furthermore, all failures occurred within the 95% treatment isodose, emphasizing the fact that the delineation of the true GTV remains essential. This is consistent with other studies that have shown that the vast majority of recurrences occurred within the high dose region [23][24][25][26][27][28]. In this respect, as already demonstrated by others, it's crucial to use validated methodology, in particular for the automatic delineation of the FDG-PET GTV [29].…”

Analysis of CT-verified loco-regional recurrences after definitive IMRT for HNSCC using site of origin estimation methods

“…The number of CT-verified T-and N-site loco-regional recurrences inside high-dose treatment volume was lower than observed in other studies [4,10,19]. The GTV-CTV1 margin in the present study was 0 mm in 80% of cases, whereas other centers use up to 10 mm margins around GTV or even the entire region harboring the tumor [10][11][12].…”

Patterns of Treatment Failure and Postrecurrence Outcomes Among Patients With Locally Advanced Head and Neck Squamous Cell Carcinoma After Chemoradiotherapy Using Modern Radiation Techniques

“…29,30 Our study demonstrated that, in definitive cases, 87.3% of regional recurrences occurred at the sites of gross disease, with isolated recurrences in elective nodal volumes occurring in less than 1% of cases, similar to prior work. 31,32 The low rate of treatment failures in electively treated nodal basins raises the possibility that the dose of radiation to these areas may be reduced or possibly eliminated in select cases, as suggested by a recent prospective trial that demonstrated no compromise in outcomes with elimination of elective nodal coverage in select patients who responded well to induction chemotherapy. 33 We identified 3 cases of recurrence in the anterior superficial lymphatic chain after IMRT for OCC, a location that is not traditionally ascribed significant risk, although treatment failures have been previously noted.…”