Smart (simultaneous modulated accelerated radiation therapy) boost: a new accelerated fractionation schedule for the treatment of head and neck cancer with intensity modulated radiotherapy

Butler, E. Brian; Teh, Bin S.; Grant, Walter H.; Uhl, Barry M.; Kuppersmith, Ronald B.; Chiu, J. Kam; Donovan, Donald T.; Woo, Shiao Y.

doi:10.1016/s0360-3016(99)00101-7

Cited by 267 publications

(121 citation statements)

References 16 publications

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“…Others have previously shown that dose escalation of the PET abnormality is feasible in select patients [24,30,31]. Such areas could be part of a simultaneous integrated boost [32,33]. It is unclear whether these targets for dose escalation should be defined by, visual interpretation [11], a threshold intensity plateau [28], or if the boost dose intensity should be specifically tailored to each imaging voxel intensity (i.e.…”

Section: Discussionmentioning

confidence: 99%

Correlation between pretreatment FDG-PET biological target volume and anatomical location of failure after radiation therapy for head and neck cancers

Soto¹,

Kessler²,

Piert³

et al. 2008

Radiotherapy and Oncology

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Section: Discussionmentioning

confidence: 99%

Correlation between pretreatment FDG-PET biological target volume and anatomical location of failure after radiation therapy for head and neck cancers

Soto¹,

Kessler²,

Piert³

et al. 2008

Radiotherapy and Oncology

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“…A major advantage of IMRT is that it opens the possibilities for concomitant delivery of different doses to different target volumes, e.g., combining two-phase treatments using integrated boosts as well as local dose escalation (34)(35)(36)(37). For the current patient group, we have recently introduced a Phase II study in which we simultaneously treat both the pelvic lymph nodes (with conventional fractionation, i.e., 2 Gy per fraction) combined with hypofractionated doses (2.4-2.7 Gy per fraction) to the prostate and seminal vesicles (38,39).…”

Section: Discussionmentioning

confidence: 99%

Intensity-Modulated Radiotherapy of Pelvic Lymph Nodes in Locally Advanced Prostate Cancer: Planning Procedures and Early Experiences

Muren

Wasbø

Helle

et al. 2008

International Journal of Radiation Oncology*Biology*Physics

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Purpose: We present planning and early clinical outcomes of a study of intensity-modulated radiotherapy (IMRT) for locally advanced prostate cancer. Methods and Materials: A total of 43 patients initially treated with an IMRT plan delivering 50 Gy to the prostate, seminal vesicles, and pelvic lymph nodes, followed by a conformal radiotherapy (CRT) plan delivering 20 Gy to the prostate and seminal vesicles, were studied. Dose-volume histogram (DVH) data for the added plans were compared with dose-volume histogram data for the sum of two CRT plans for 15 cases. Gastrointestinal (GI) and genitourinary (GU) toxicity, based on the Radiation Therapy Oncology Group scoring system, was recorded weekly throughout treatment as well as 3 to 18 months after treatment and are presented. Results: Treatment with IMRT both reduced normal tissue doses and increased the minimum target doses. Intestine volumes receiving more than 40 and 50 Gy were significantly reduced (e.g., at 50 Gy, from 81 to 19 cm 3 ; p = 0.026), as were bladder volumes above 40, 50, and 60 Gy, rectum volumes above 30, 50, and 60 Gy, and hip joint muscle volumes above 20, 30, and 40 Gy. During treatment, Grade 2 GI toxicity was reported by 12 of 43 patients (28%), and Grade 2 to 4 GU toxicity was also observed among 12 patients (28%). With 6 to 18 months of follow-up, 2 patients (5%) experienced Grade 2 GI effects and 7 patients (16%) experienced Grade 2 GU effects. Conclusions: Use of IMRT for pelvic irradiation in prostate cancer reduces normal tissue doses, improves target coverage, and has a promising toxicity profile. Ó

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“…These factors make any attempt to compare the results of different IMRT series, or even series of IMRT with series of conventional RT, futile. Notwithstanding these limitations, all series of IMRT outcome have reported outstanding locoregional control rates for oropharyngeal cancer [11,12,[43][44][45]. These series reported 2-year locoregional tumor control rates of 90%-98% for patient populations consisting mainly of stage III-IV tumors.…”

Section: Imrt For Oropharyngeal Carcinomamentioning

confidence: 99%

Intensity-Modulated Radiation Therapy for Head and Neck Carcinoma

et al. 2007

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After completing this course, the reader will be able to:1. Outline innovations related to targeted radiation therapy.2. Describe trials proving an advantage using IMRT.3. Assess treatment planning modalities and how IMRT fields are designed.4. Evaluate when there is a toxicity advantage for IMRT.5. Discern when conventional radiotherapy should be used instead of IMRT.Access and take the CME test online and receive 1 AMA PRA Category 1 Credit ™ at CME.TheOncologist.com CME CME ABSTRACT Intensity-modulated radiation therapy (IMRT) for head and neck tumors refers to a new approach that aims at increasing the radiation dose gradient between the target tissues and the surrounding normal tissues at risk, thus offering the prospect of increasing the locoregional control probability while decreasing the complication rate. As a prerequisite, IMRT requires a proper selection and delineation of target volumes. For the latter, recent data indicate the potential of functional imaging to complement anatomic imaging modalities. Nonrandomized clinical series in paranasal sinuses and pharyngolaryngeal carcinoma have shown that IMRT was able to achieve a very high rate of locoregional control with less morbidity, such as dry-eye syndrome, xerostomia, and swallowing dysfunction. The promising results of IMRT are likely to be achieved when many treatment conditions are met, for example, optimal selection and delineation of the target volumes and organs at risk, appropriate physical quality control of the irradiation, and accurate patient setup with the use of onboard imaging. Because of the complexity of the various tasks, it is thus likely that these conditions will only be

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Smart (simultaneous modulated accelerated radiation therapy) boost: a new accelerated fractionation schedule for the treatment of head and neck cancer with intensity modulated radiotherapy

Cited by 267 publications

References 16 publications

Correlation between pretreatment FDG-PET biological target volume and anatomical location of failure after radiation therapy for head and neck cancers

Correlation between pretreatment FDG-PET biological target volume and anatomical location of failure after radiation therapy for head and neck cancers

Intensity-Modulated Radiotherapy of Pelvic Lymph Nodes in Locally Advanced Prostate Cancer: Planning Procedures and Early Experiences

Intensity-Modulated Radiation Therapy for Head and Neck Carcinoma

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