A M Chen1,2, S Hsu3, J Lamb3, Y Yang3, N Agazaryan3, M L Steinberg3, D A Low3, M Cao3. 1. Department of Radiation Oncology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90095, USA. achen5@kumc.edu. 2. Department of Radiation Oncology, University of Kansas School of Medicine, 3901 Rainbow Blvd, MS 4033, Kansas City, KS, 66160, USA. achen5@kumc.edu. 3. Department of Radiation Oncology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90095, USA.
Abstract
PURPOSE: To report a single-institutional experience with the use of magnetic resonance imaging (MRI)-guided radiotherapy for cancers of the head and neck. MATERIALS AND METHODS: Between October 2014 and October 2016, 18 patients with newly diagnosed cancers of the head and neck were prospectively enrolled on an institutional registry trial investigating the feasibility and efficacy of external-beam radiotherapy delivered using on-board MRI. All patients had biopsy-proven evidence of malignancy, measurable disease, and the ability to provide consent. None had previously received any treatment. Median dose was 70 Gy (range 54-70 Gy). MRI scans were obtained as part of an image-guided registration protocol for alignment prior to and during each treatment. Concurrent chemotherapy was administered to 14 patients (78%). Patient-reported outcomes were assessed using the University of Washington quality of life instrument. RESULTS: Seventeen of 18 patients completed the planned intensity-modulated radiotherapy (IMRT) treatment of which 15 (83%) had a complete response and 2 (11%) had a partial response based on initial post-therapy positron emission tomography (PET) at 3 months. The 1-year estimates of progression-free survival, overall survival, and local-regional control were 95, 96, and 95%, respectively. There were no treatment-related fatalities. The incidence of grade 3+ acute toxicity was 44%. The proportion of patients rating their health-related quality of life as "very good" or "outstanding" at 6 months and 1 year after completion of radiation therapy was 60 and 70%, respectively. CONCLUSIONS: MRI-guided radiotherapy achieves clinical outcomes comparable to contemporary series reporting on IMRT for head and neck cancer.
PURPOSE: To report a single-institutional experience with the use of magnetic resonance imaging (MRI)-guided radiotherapy for cancers of the head and neck. MATERIALS AND METHODS: Between October 2014 and October 2016, 18 patients with newly diagnosed cancers of the head and neck were prospectively enrolled on an institutional registry trial investigating the feasibility and efficacy of external-beam radiotherapy delivered using on-board MRI. All patients had biopsy-proven evidence of malignancy, measurable disease, and the ability to provide consent. None had previously received any treatment. Median dose was 70 Gy (range 54-70 Gy). MRI scans were obtained as part of an image-guided registration protocol for alignment prior to and during each treatment. Concurrent chemotherapy was administered to 14 patients (78%). Patient-reported outcomes were assessed using the University of Washington quality of life instrument. RESULTS: Seventeen of 18 patients completed the planned intensity-modulated radiotherapy (IMRT) treatment of which 15 (83%) had a complete response and 2 (11%) had a partial response based on initial post-therapy positron emission tomography (PET) at 3 months. The 1-year estimates of progression-free survival, overall survival, and local-regional control were 95, 96, and 95%, respectively. There were no treatment-related fatalities. The incidence of grade 3+ acute toxicity was 44%. The proportion of patients rating their health-related quality of life as "very good" or "outstanding" at 6 months and 1 year after completion of radiation therapy was 60 and 70%, respectively. CONCLUSIONS: MRI-guided radiotherapy achieves clinical outcomes comparable to contemporary series reporting on IMRT for head and neck cancer.
Entities:
Keywords:
Head and neck; IMRT; Image-guidance; MRI; Radiotherapy
Authors: Yanle Hu; Leith Rankine; Olga L Green; Rojano Kashani; H Harold Li; Hua Li; Roger Nana; Vivian Rodriguez; Lakshmi Santanam; Shmaryu Shvartsman; James Victoria; H Omar Wooten; James F Dempsey; Sasa Mutic Journal: Med Phys Date: 2015-10 Impact factor: 4.071
Authors: H Omar Wooten; Vivian Rodriguez; Olga Green; Rojano Kashani; Lakshmi Santanam; Kari Tanderup; Sasa Mutic; H Harold Li Journal: Radiother Oncol Date: 2015-03-04 Impact factor: 6.280
Authors: Joseph Weygand; Clifton David Fuller; Geoffrey S Ibbott; Abdallah S R Mohamed; Yao Ding; Jinzhong Yang; Ken-Pin Hwang; Jihong Wang Journal: Int J Radiat Oncol Biol Phys Date: 2016-03-02 Impact factor: 7.038
Authors: H Omar Wooten; Olga Green; Min Yang; Todd DeWees; Rojano Kashani; Jeff Olsen; Jeff Michalski; Deshan Yang; Kari Tanderup; Yanle Hu; H Harold Li; Sasa Mutic Journal: Int J Radiat Oncol Biol Phys Date: 2015-03-17 Impact factor: 7.038
Authors: David L Schwartz; Adam S Garden; Jimmy Thomas; Yipei Chen; Yongbin Zhang; Jan Lewin; Mark S Chambers; Lei Dong Journal: Int J Radiat Oncol Biol Phys Date: 2011-12-02 Impact factor: 7.038
Authors: H Harold Li; Vivian L Rodriguez; Olga L Green; Yanle Hu; Rojano Kashani; H Omar Wooten; Deshan Yang; Sasa Mutic Journal: Int J Radiat Oncol Biol Phys Date: 2014-10-25 Impact factor: 7.038
Authors: Min Yao; Kenneth J Dornfeld; John M Buatti; Mark Skwarchuk; Huaming Tan; Thanh Nguyen; Judith Wacha; John E Bayouth; Gerry F Funk; Russell B Smith; Scott M Graham; Kristi Chang; Henry T Hoffman Journal: Int J Radiat Oncol Biol Phys Date: 2005-10-01 Impact factor: 7.038
Authors: Yingli Yang; Minsong Cao; Ke Sheng; Yu Gao; Allen Chen; Mitch Kamrava; Percy Lee; Nzhde Agazaryan; James Lamb; David Thomas; Daniel Low; Peng Hu Journal: Med Phys Date: 2016-03 Impact factor: 4.071
Authors: K S Clifford Chao; Gokhan Ozyigit; Binh N Tran; Mustafa Cengiz; James F Dempsey; Daniel A Low Journal: Int J Radiat Oncol Biol Phys Date: 2003-02-01 Impact factor: 7.038
Authors: Tilman Bostel; Nils H Nicolay; Jörg G Grossmann; Angela Mohr; Stefan Delorme; Gernot Echner; Peter Häring; Jürgen Debus; Florian Sterzing Journal: Radiat Oncol Date: 2014-01-09 Impact factor: 3.481
Authors: William A Hall; Eric Paulson; X Allen Li; Beth Erickson; Christopher Schultz; Alison Tree; Musaddiq Awan; Daniel A Low; Brigid A McDonald; Travis Salzillo; Carri K Glide-Hurst; Amar U Kishan; Clifton D Fuller Journal: CA Cancer J Clin Date: 2021-11-18 Impact factor: 508.702