Long-term experience with reduced planning target volume margins and intensity-modulated radiotherapy with daily image-guidance for head and neck cancer

Allen M. Chen, Yao Yu, Megan E Daly, D Gregory Farwell, Stanley H Benedict, James A. Purdy

Research output: Contribution to journalArticle

27 Scopus citations

Abstract

Background. The purpose of this study was to compare outcomes among patients treated by intensity-modulated radiotherapy (IMRT) with daily image-guided radiotherapy (IGRT) for head and neck cancer according to the margins used to expand the clinical target volume (CTV) to create a planning target volume (PTV).

Methods. Three hundred sixty-seven consecutive patients were treated with IMRT for squamous cell carcinoma of the head and neck. The first 103 patients were treated with 5-mm CTV-to-PTV margins. The subsequent 264 patients were treated using reduced (3 mm) margins.

Results. The 3-year locoregional control for patients treated using 5-mm and 3-mm CTV-to-PTV margins, respectively, was 78% and 80% (p 5 .75). The incidence of gastrostomy-tube dependence at 1 year was 10% and 3%, respectively (p 5 .001). The incidence of posttreatment esophageal stricture was 14% and 7%, respectively (p 5 .01).

Conclusion. The use of reduced (3 mm) CTV-to-PTV margins was associated with reduced late toxicity while maintaining locoregional control.

Original languageEnglish (US)
Pages (from-to)1766-1772
Number of pages7
JournalHead and Neck
Volume36
Issue number12
DOIs
StatePublished - Dec 1 2014

Keywords

  • Head and neck cancer
  • Image-guided radiotherapy
  • Intensity-modulated radiotherapy
  • Marginal misses
  • Planning target volume

ASJC Scopus subject areas

  • Otorhinolaryngology

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