PURPOSE: To report a single-institutional experience using intensity-modulated radiotherapy with daily image-guided radiotherapy for the reirradiation of recurrent and second cancers of the head and neck. METHODS AND MATERIALS: Twenty-one consecutive patients were prospectively treated with intensity-modulated radiotherapy from February 2006 to March 2009 to a median dose of 66 Gy (range, 60-70 Gy). None of these patients received concurrent chemotherapy. Daily helical megavoltage CT scans were obtained before each fraction as part of an image-guided radiotherapy registration protocol for patient alignment. RESULTS: The 1- and 2-year estimates of in-field control were 72% and 65%, respectively. A total of 651 daily megavoltage CT scans were obtained. The mean systematic shift to account for interfraction motion was 1.38 ± 1.25 mm, 1.79 ± 1.45 mm, and 1.98 ± 1.75 mm for the medial-lateral, superior-inferior, and anterior-posterior directions, respectively. Pretreatment shifts of >3 mm occurred in 19% of setups in the medial-lateral, 27% in the superior-inferior, and 33% in the anterior-posterior directions, respectively. There were no treatment-related fatalities or hospitalizations. Complications included skin desquamation, odynophagia, otitis externa, keratitis, naso-lacrimal duct stenosis, and brachial plexopathy. CONCLUSIONS: Intensity-modulated radiotherapy with daily image guidance results in effective disease control with relatively low morbidity and should be considered for selected patients with recurrent and second primary cancers of the head and neck.
PURPOSE: To report a single-institutional experience using intensity-modulated radiotherapy with daily image-guided radiotherapy for the reirradiation of recurrent and second cancers of the head and neck. METHODS AND MATERIALS: Twenty-one consecutive patients were prospectively treated with intensity-modulated radiotherapy from February 2006 to March 2009 to a median dose of 66 Gy (range, 60-70 Gy). None of these patients received concurrent chemotherapy. Daily helical megavoltage CT scans were obtained before each fraction as part of an image-guided radiotherapy registration protocol for patient alignment. RESULTS: The 1- and 2-year estimates of in-field control were 72% and 65%, respectively. A total of 651 daily megavoltage CT scans were obtained. The mean systematic shift to account for interfraction motion was 1.38 ± 1.25 mm, 1.79 ± 1.45 mm, and 1.98 ± 1.75 mm for the medial-lateral, superior-inferior, and anterior-posterior directions, respectively. Pretreatment shifts of >3 mm occurred in 19% of setups in the medial-lateral, 27% in the superior-inferior, and 33% in the anterior-posterior directions, respectively. There were no treatment-related fatalities or hospitalizations. Complications included skin desquamation, odynophagia, otitis externa, keratitis, naso-lacrimal duct stenosis, and brachial plexopathy. CONCLUSIONS: Intensity-modulated radiotherapy with daily image guidance results in effective disease control with relatively low morbidity and should be considered for selected patients with recurrent and second primary cancers of the head and neck.
Authors: Julie Schatteman; Dirk Van Gestel; Dieter Berwouts; Werner De Gersem; Geert De Kerf; Wilfried De Neve; Bie De Ost; Ana Maria Luiza Olteanu; Sylvie Rottey; Tom Vercauteren; Ingeborg Goethals; Fréderic Duprez Journal: Strahlenther Onkol Date: 2018-03-19 Impact factor: 3.621
Authors: Nadeem Riaz; Julian C Hong; Eric J Sherman; Luc Morris; Matthew Fury; Ian Ganly; Tony J C Wang; Weji Shi; Suzanne L Wolden; Andrew Jackson; Richard J Wong; Zhigang Zhang; Shyam D Rao; Nancy Y Lee Journal: Radiother Oncol Date: 2014-06-30 Impact factor: 6.280
Authors: Allen M Chen; Minsong Cao; Sophia Hsu; James Lamb; Argin Mikaeilian; Yingli Yang; Nzhde Agazaryan; Daniel A Low; Michael L Steinberg Journal: Adv Radiat Oncol Date: 2017-02-21
Authors: Sana D Karam; James W Snider; Hongkun Wang; Margaux Wooster; Christopher Lominska; John Deeken; Kenneth Newkirk; Bruce Davidson; K William Harter Journal: J Radiat Oncol Date: 2012-02-19