Clinical outcomes among patients with head and neck cancer treated by intensity-modulated radiotherapy with and without adaptive replanning

Allen M. Chen, Megan E Daly, Jing Cui, Mathew Mathai, Stanley H Benedict, James A. Purdy

Research output: Contribution to journalArticle

44 Citations (Scopus)

Abstract

BACKGROUND: The purpose of this study was to determine the effect of adaptive replanning on clinical outcome among patients treated by intensity-modulated radiotherapy (IMRT) for head and neck cancer.

METHODS: Three hundred seventeen patients underwent IMRT with daily image-guidance for newly diagnosed squamous cell carcinoma of the head and neck to a median dose of 66 Gy (range, 60-74 Gy). Of these 317 patients, 51 (16%) underwent adaptive radiotherapy with modification of the original IMRT midway during treatment.

RESULTS: The 2-year local-regional control was 88% for patients treated with adaptive replanning compared with 79% for patients treated without (p = .01). The median time to local-regional recurrence for the 4 patients treated by adaptive radiotherapy was 7 months (range, 3-15 months) with all failures occurring within the high-dose planning target volume (PTV).

CONCLUSION: Although the use of routine replanning is probably not necessary, our findings do suggest a significant benefit in appropriately selected patients.

Original languageEnglish (US)
Pages (from-to)1541-1546
Number of pages6
JournalHead and Neck
Volume36
Issue number11
DOIs
StatePublished - Nov 1 2014

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Intensity-Modulated Radiotherapy
Head and Neck Neoplasms
Radiotherapy
Recurrence

Keywords

  • adaptive radiotherapy
  • head and neck cancer
  • image-guidance
  • intensity-modulated radiotherapy (IMRT)
  • outcomes

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Clinical outcomes among patients with head and neck cancer treated by intensity-modulated radiotherapy with and without adaptive replanning. / Chen, Allen M.; Daly, Megan E; Cui, Jing; Mathai, Mathew; Benedict, Stanley H; Purdy, James A.

In: Head and Neck, Vol. 36, No. 11, 01.11.2014, p. 1541-1546.

Research output: Contribution to journalArticle

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AU - Daly, Megan E

AU - Cui, Jing

AU - Mathai, Mathew

AU - Benedict, Stanley H

AU - Purdy, James A.

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AB - BACKGROUND: The purpose of this study was to determine the effect of adaptive replanning on clinical outcome among patients treated by intensity-modulated radiotherapy (IMRT) for head and neck cancer.METHODS: Three hundred seventeen patients underwent IMRT with daily image-guidance for newly diagnosed squamous cell carcinoma of the head and neck to a median dose of 66 Gy (range, 60-74 Gy). Of these 317 patients, 51 (16%) underwent adaptive radiotherapy with modification of the original IMRT midway during treatment.RESULTS: The 2-year local-regional control was 88% for patients treated with adaptive replanning compared with 79% for patients treated without (p = .01). The median time to local-regional recurrence for the 4 patients treated by adaptive radiotherapy was 7 months (range, 3-15 months) with all failures occurring within the high-dose planning target volume (PTV).CONCLUSION: Although the use of routine replanning is probably not necessary, our findings do suggest a significant benefit in appropriately selected patients.

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