PURPOSE: Analysis of locoregional failure in head-and-neck cancer (HNC) following intensity-modulated radiation therapy (IMRT), with focus on the location of locoregional failures in relation to the chosen planning target volumes (PTVs) and dose distributions. PATIENTS AND METHODS: Between January 2002 and May 2006, 280 HNC patients were subjected to IMRT at the authors' institution. Mean follow-up was 23.2 months (3-59.3 months). Definitive IMRT was performed in 75% of all patients. In 71%, simultaneous cisplatin-based chemotherapy was given. 70% of patients presented with T3/4, T1-2 N2c/3 or recurred disease. Locoregional failure patterns were analyzed. RESULTS: 2-year local, nodal, distant, disease-free, and overall survival rates were 80%, 87%, 87%, 73%, and 82%, respectively. 46 local (16%) and 31 nodal (11%) failures have been observed so far. Local tumor persistence was seen in 23/46 cases (50%), and nodal persistence in 12/31 (39%), respectively. One marginal local failure developed in a patient referred for a recurred oral cavity tumor. Three nodal failures developed outside the PTVs at unexpected locations. All other failures have been confirmed "in field". No failure occurred in level Ib or upper level II. Local failure occurred mainly following definitive IMRT for large tumors, nodal failure only in nodally positive patients with nodal high-risk features. CONCLUSION: The dose-volume concept as used here has shown to be adequate, with disease failure developing at the site of the initial gross tumor manifestation inside the boost volume.
PURPOSE: Analysis of locoregional failure in head-and-neck cancer (HNC) following intensity-modulated radiation therapy (IMRT), with focus on the location of locoregional failures in relation to the chosen planning target volumes (PTVs) and dose distributions. PATIENTS AND METHODS: Between January 2002 and May 2006, 280 HNC patients were subjected to IMRT at the authors' institution. Mean follow-up was 23.2 months (3-59.3 months). Definitive IMRT was performed in 75% of all patients. In 71%, simultaneous cisplatin-based chemotherapy was given. 70% of patients presented with T3/4, T1-2 N2c/3 or recurred disease. Locoregional failure patterns were analyzed. RESULTS: 2-year local, nodal, distant, disease-free, and overall survival rates were 80%, 87%, 87%, 73%, and 82%, respectively. 46 local (16%) and 31 nodal (11%) failures have been observed so far. Local tumor persistence was seen in 23/46 cases (50%), and nodal persistence in 12/31 (39%), respectively. One marginal local failure developed in a patient referred for a recurred oral cavity tumor. Three nodal failures developed outside the PTVs at unexpected locations. All other failures have been confirmed "in field". No failure occurred in level Ib or upper level II. Local failure occurred mainly following definitive IMRT for large tumors, nodal failure only in nodally positive patients with nodal high-risk features. CONCLUSION: The dose-volume concept as used here has shown to be adequate, with disease failure developing at the site of the initial gross tumor manifestation inside the boost volume.
Authors: A K Due; I R Vogelius; M C Aznar; S M Bentzen; A K Berthelsen; S S Korreman; C A Kristensen; L Specht Journal: Strahlenther Onkol Date: 2012-05-13 Impact factor: 3.621
Authors: Hilke Vorwerk; Daniela Wagner; Björn Seitz; Hans Christiansen; Hendrik A Wolff; Clemens F Hess Journal: Strahlenther Onkol Date: 2009-12 Impact factor: 3.621
Authors: Rainer Joachim Strege; György Kovács; Jens Eduard Meyer; Detlef Holland; Alexander Claviez; Maximilian H Mehdorn Journal: Strahlenther Onkol Date: 2009-12 Impact factor: 3.621
Authors: M de Ridder; Z A R Gouw; J J Sonke; A Navran; B Jasperse; J Heukelom; M E T Tesselaar; W M C Klop; M W M van den Brekel; Abrahim Al-Mamgani Journal: Eur Arch Otorhinolaryngol Date: 2016-12-09 Impact factor: 2.503
Authors: Arno Olthoff; Andreas Ewen; Hendrik Andreas Wolff; Robert Michael Hermann; Hilke Vorwerk; Andrea Hille; Ralph Rödel; Clemens F Hess; Wolfgang Steiner; Olivier Pradier; Hans Christiansen Journal: Strahlenther Onkol Date: 2009-05-15 Impact factor: 3.621