BACKGROUND: The purpose of this study was to compare the patterns of failure focusing on the distribution of local-regional recurrence among patients treated postoperatively with conventional radiotherapy (RT) and intensity-modulated radiotherapy (IMRT) for head and neck cancer. METHODS: The records of 130 patients treated by surgery and postoperative radiation therapy for squamous cell carcinoma of the head and neck were reviewed. Seventy-eight patients (60%) were treated using conventional RT and 52 patients (40%) were treated using IMRT. RESULTS: The 3-year estimates of local-regional control were 70% and 73% among patients treated by conventional RT and IMRT, respectively (p = .33). Among the local-regional recurrences in the IMRT group, 9 were in-field recurrences occurring within the physician-designated clinical target volume (CTV), and 4 were marginal recurrences involving the contralateral neck adjacent to the spared parotid gland (3 patients) and the retropharyngeal/retrostyloid lymph node region (1 patient). CONCLUSION: Our study showed that conventional RT and IMRT result in similar rates of local-regional control. The implications for CTV design are discussed herein.
BACKGROUND: The purpose of this study was to compare the patterns of failure focusing on the distribution of local-regional recurrence among patients treated postoperatively with conventional radiotherapy (RT) and intensity-modulated radiotherapy (IMRT) for head and neck cancer. METHODS: The records of 130 patients treated by surgery and postoperative radiation therapy for squamous cell carcinoma of the head and neck were reviewed. Seventy-eight patients (60%) were treated using conventional RT and 52 patients (40%) were treated using IMRT. RESULTS: The 3-year estimates of local-regional control were 70% and 73% among patients treated by conventional RT and IMRT, respectively (p = .33). Among the local-regional recurrences in the IMRT group, 9 were in-field recurrences occurring within the physician-designated clinical target volume (CTV), and 4 were marginal recurrences involving the contralateral neck adjacent to the spared parotid gland (3 patients) and the retropharyngeal/retrostyloid lymph node region (1 patient). CONCLUSION: Our study showed that conventional RT and IMRT result in similar rates of local-regional control. The implications for CTV design are discussed herein.
Authors: Dirk Van Gestel; Dirk Verellen; Lien Van De Voorde; Bie de Ost; Geert De Kerf; Olivier Vanderveken; Carl Van Laer; Danielle Van den Weyngaert; Jan B Vermorken; Vincent Gregoire Journal: Oncologist Date: 2013-05-30