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

20 Citations (Scopus)

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

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Intensity-Modulated Radiotherapy
Head and Neck Neoplasms
Image-Guided Radiotherapy
Esophageal Stenosis
Gastrostomy
Incidence

Keywords

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

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

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title = "Long-term experience with reduced planning target volume margins and intensity-modulated radiotherapy with daily image-guidance for head and neck cancer",
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.",
keywords = "Head and neck cancer, Image-guided radiotherapy, Intensity-modulated radiotherapy, Marginal misses, Planning target volume",
author = "Chen, {Allen M.} and Yao Yu and Daly, {Megan E} and Farwell, {D Gregory} and Benedict, {Stanley H} and Purdy, {James A.}",
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T1 - Long-term experience with reduced planning target volume margins and intensity-modulated radiotherapy with daily image-guidance for head and neck cancer

AU - Chen, Allen M.

AU - Yu, Yao

AU - Daly, Megan E

AU - Farwell, D Gregory

AU - Benedict, Stanley H

AU - Purdy, James A.

PY - 2014/12/1

Y1 - 2014/12/1

N2 - 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.

AB - 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.

KW - Head and neck cancer

KW - Image-guided radiotherapy

KW - Intensity-modulated radiotherapy

KW - Marginal misses

KW - Planning target volume

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