Hideya Yamazaki1,2, Yusuke Demizu3, Tomoaki Okimoto3, Mikio Ogita4, Kengo Himei5, Satoaki Nakamura6, Gen Suzuki6, Ken Yoshida7, Tadayuki Kotsuma7, Yasuo Yoshioka8, Ryoongjin Oh9. 1. Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajiicho Kawaramachi Hirokoji, 602-8566, Kamigyo-ku, Kyoto, Japan. hideya10@hotmail.com. 2. CyberKnife Center, Soseikai General Hospital, 126 Kami-Misu, Shimotoba Fushimi-ku, Kyoto, Japan. hideya10@hotmail.com. 3. Department of Radiology, Hyogo Ion Beam Medical Center, 1-2-1 Kouto, Shingu-cho, 679-5165, Tatsuno, Hyogo, Japan. 4. Radiotherapy Department, Fujimoto Hayasuzu Hospital, Hayasuzu 17-1, 885-0055, Miyakonojo, Miyazaki, Japan. 5. Department of Radiology, Japanese Red Cross Okayama Hospital, Aoe 2‑1-1, Kita-ku, 700-8607, Okayama, Okayama, Japan. 6. Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajiicho Kawaramachi Hirokoji, 602-8566, Kamigyo-ku, Kyoto, Japan. 7. Department of Radiation Oncology, National Hospital Organization Osaka National Hospital, 2-1-14, Hoenzaka, Chuo-ku, 540-0006, Osaka, Osaka, Japan. 8. Department of Radiation Oncology, Osaka University Graduate School of Medicine, 565-0871, Suita, Osaka, Japan. 9. Miyakojima IGRT Clinic, 534-0021, Osaka, Japan.
Abstract
OBJECTIVE: To examine the outcomes of reirradiation for recurrent head and neck cancers using different modalities. METHODS: This retrospective study included 26 patients who received charged particle radiotherapy (CP) and 150 who received photon radiotherapy (117 CyberKnife radiotherapy [CK] and 36 intensity-modulated radiotherapy [IMRT]). Inverse probability of treatment weighting (IPTW) involving propensity scores was used to reduce background selection bias. RESULTS: Higher prescribed doses were used in CP than photon radiotherapy. The 1‑year overall survival (OS) rates were 67.9% for CP and 54.1% for photon radiotherapy (p = 0.15; 55% for CK and 51% for IMRT). In multivariate Cox regression, the significant prognostic factors for better survival were nasopharyngeal cancer, higher prescribed dose, and lower tumor volume. IPTW showed a statistically significant difference between CP and photon radiotherapy (p = 0.04). The local control rates for patients treated with CP and photon radiotherapy at 1 year were 66.9% (range 46.3-87.5%) and 67.1% (range 58.3-75.9%), respectively. A total of 48 patients (27%) experienced toxicity grade ≥3 (24% in the photon radiotherapy group and 46% in the CP group), including 17 patients with grade 5 toxicity. Multivariate analysis revealed that younger age and a larger planning target volume (PTV) were significant risk factors for grade 3 or worse toxicity. CONCLUSION: CP provided superior survival outcome compared to photon radiotherapy. Tumor volume, primary site (nasopharyngeal), and prescribed dose were identified as survival factors. Younger patients with a larger PTV experienced toxicity grade ≥3.
OBJECTIVE: To examine the outcomes of reirradiation for recurrent head and neck cancers using different modalities. METHODS: This retrospective study included 26 patients who received charged particle radiotherapy (CP) and 150 who received photon radiotherapy (117 CyberKnife radiotherapy [CK] and 36 intensity-modulated radiotherapy [IMRT]). Inverse probability of treatment weighting (IPTW) involving propensity scores was used to reduce background selection bias. RESULTS: Higher prescribed doses were used in CP than photon radiotherapy. The 1‑year overall survival (OS) rates were 67.9% for CP and 54.1% for photon radiotherapy (p = 0.15; 55% for CK and 51% for IMRT). In multivariate Cox regression, the significant prognostic factors for better survival were nasopharyngeal cancer, higher prescribed dose, and lower tumor volume. IPTW showed a statistically significant difference between CP and photon radiotherapy (p = 0.04). The local control rates for patients treated with CP and photon radiotherapy at 1 year were 66.9% (range 46.3-87.5%) and 67.1% (range 58.3-75.9%), respectively. A total of 48 patients (27%) experienced toxicity grade ≥3 (24% in the photon radiotherapy group and 46% in the CP group), including 17 patients with grade 5 toxicity. Multivariate analysis revealed that younger age and a larger planning target volume (PTV) were significant risk factors for grade 3 or worse toxicity. CONCLUSION: CP provided superior survival outcome compared to photon radiotherapy. Tumor volume, primary site (nasopharyngeal), and prescribed dose were identified as survival factors. Younger patients with a larger PTV experienced toxicity grade ≥3.
Entities:
Keywords:
Charged particle radiotherapy; Head and neck neoplasms; Intensity-modulated radiotherapy; Reirradiation; Stereotactic radiotherapy
Authors: Sharon A Spencer; Jonathan Harris; Richard H Wheeler; Mitchell Machtay; Christopher Schultz; William Spanos; Marvin Rotman; Ruby Meredith; Kie-Kian Ang Journal: Head Neck Date: 2008-03 Impact factor: 3.147
Authors: Eric F Lartigau; Emmanuelle Tresch; Juliette Thariat; Pierre Graff; Bernard Coche-Dequeant; Karen Benezery; Luis Schiappacasse; Marian Degardin; Pierre-Yves Bondiau; Didier Peiffert; Jean-Louis Lefebvre; Thomas Lacornerie; Andrew Kramar Journal: Radiother Oncol Date: 2013-11-18 Impact factor: 6.280
Authors: Mauricio E Gamez; Samir H Patel; Lisa A McGee; Terence T Sio; Mark McDonald; Jack Phan; Daniel J Ma; Robert L Foote; Jean-Claude M Rwigema Journal: Int J Part Ther Date: 2021-06-25