Jean-Emmanuel Bibault1, Sophie Dussart2, Pascal Pommier2, Magali Morelle3, Marius Huguet4, Pierre Boisselier5, Bernard Coche-Dequeant6, Marc Alfonsi7, Etienne Bardet8, Michel Rives9, Valentin Calugaru10, Enrique Chajon11, Georges Noel12, Hinda Mecellem13, Stephanie Servagi Vernat14, Lionel Perrier3, Philippe Giraud15. 1. Radiation Oncology Department, Paris Descartes University, Paris Sorbonne Cité, Hôpital Européen Georges Pompidou, Paris, France. 2. Radiation Oncology Department, Leon Berard Cancer Centre, Lyon, France. 3. GATE L-SE UMR 5824, Lyon University, Léon Bérard Cancer Center, F-69008, Lyon, France. 4. GATE L-SE UMR 5824, Lyon University, Lumière Lyon 2 University, F-69130 Écully, France. 5. Radiation Oncology Department, Montpellier Cancer Institute, Montpellier, France. 6. Radiation Oncology Department, Oscar Lambret Cancer Centre, Lille, France. 7. Radiation Oncology Department, Sainte Catherine Institute, Avignon, France. 8. Radiation Oncology Department, René Gauducheau Cancer Centre, Saint-Herblain, France. 9. Radiation Oncology Department, Claudius Regaud Institute, Toulouse, France. 10. Curie Institute, Paris, France. 11. Radiation Oncology Department, Eugène Marquis Cancer Centre, Rennes, France. 12. Radiation Oncology Department, Paul Strauss Cancer Centre, Strasbourg, France. 13. Radiation Oncology Department, Lorraine Institute of Oncology, Vandoeuvre-lès-Nancy, France. 14. Radiation Oncology Department, Jean Godinot Institute, Reims, France. 15. Radiation Oncology Department, Paris Descartes University, Paris Sorbonne Cité, Hôpital Européen Georges Pompidou, Paris, France. Electronic address: philippe.giraud@aphp.fr.
Abstract
PURPOSE: The Advanced Radiotherapy Oto-Rhino-Laryngologie (ART-ORL) study (NCT02024035) was performed to prospectively evaluate the clinical and economic aspects of helical TomoTherapy and volumetric modulated arc therapy (RapidArc, Varian Medical Systems, Palo Alto, CA) for patients with head and neck cancer. METHODS AND MATERIALS: Fourteen centers participated in this prospective comparative study. Randomization was not possible based on the availability of equipment. Patients with epidermoid or undifferentiated nasopharyngeal carcinoma or epidermoid carcinoma of the oropharynx and oral cavity (T1-T4, M0, N0-N3) were included between February 2010 and February 2012. Only the results of the clinical study are presented in this report, as the results of the economic assessment have been published previously. Inverse probability of treatment weighting using the propensity score analysis was undertaken in an effort to adjust for potential bias due to nonrandomization. Locoregional control, cancer-specific survival, and overall survival assessed 18 months after treatment, as well as long-term toxicity and salivary function, were evaluated. RESULTS: The analysis included 166 patients. The following results are given after inverse probability of treatment weighting adjustment. The locoregional control rate at 18 months was significantly better in the TomoTherapy group: 83.3% (95% confidence interval [CI], 72.5%-90.2%) versus 72.7% (95% CI, 62.1%-80.8%) in the RapidArc group (P=.025). The cancer-specific survival rate was better in the TomoTherapy group: 97.2% (95% CI, 89.3%-99.3%) versus 85.5% (95% CI, 75.8%-91.5%) in the RapidArc group (P=.014). No significant difference was shown in progression-free or overall survival. TomoTherapy induced fewer acute salivary disorders (P=.012). Posttreatment salivary function degradation was worse in the RapidArc group (P=.012). CONCLUSIONS: TomoTherapy provided better locoregional control and cancer-specific survival than RapidArc treatment, with fewer salivary disorders. No significant difference was shown in progression-free and overall survival. These results should be explored in a randomized trial.
PURPOSE: The Advanced Radiotherapy Oto-Rhino-Laryngologie (ART-ORL) study (NCT02024035) was performed to prospectively evaluate the clinical and economic aspects of helical TomoTherapy and volumetric modulated arc therapy (RapidArc, Varian Medical Systems, Palo Alto, CA) for patients with head and neck cancer. METHODS AND MATERIALS: Fourteen centers participated in this prospective comparative study. Randomization was not possible based on the availability of equipment. Patients with epidermoid or undifferentiated nasopharyngeal carcinoma or epidermoid carcinoma of the oropharynx and oral cavity (T1-T4, M0, N0-N3) were included between February 2010 and February 2012. Only the results of the clinical study are presented in this report, as the results of the economic assessment have been published previously. Inverse probability of treatment weighting using the propensity score analysis was undertaken in an effort to adjust for potential bias due to nonrandomization. Locoregional control, cancer-specific survival, and overall survival assessed 18 months after treatment, as well as long-term toxicity and salivary function, were evaluated. RESULTS: The analysis included 166 patients. The following results are given after inverse probability of treatment weighting adjustment. The locoregional control rate at 18 months was significantly better in the TomoTherapy group: 83.3% (95% confidence interval [CI], 72.5%-90.2%) versus 72.7% (95% CI, 62.1%-80.8%) in the RapidArc group (P=.025). The cancer-specific survival rate was better in the TomoTherapy group: 97.2% (95% CI, 89.3%-99.3%) versus 85.5% (95% CI, 75.8%-91.5%) in the RapidArc group (P=.014). No significant difference was shown in progression-free or overall survival. TomoTherapy induced fewer acute salivary disorders (P=.012). Posttreatment salivary function degradation was worse in the RapidArc group (P=.012). CONCLUSIONS: TomoTherapy provided better locoregional control and cancer-specific survival than RapidArc treatment, with fewer salivary disorders. No significant difference was shown in progression-free and overall survival. These results should be explored in a randomized trial.
Authors: Kenneth C W Wong; Edwin P Hui; Kwok-Wai Lo; Wai Kei Jacky Lam; David Johnson; Lili Li; Qian Tao; Kwan Chee Allen Chan; Ka-Fai To; Ann D King; Brigette B Y Ma; Anthony T C Chan Journal: Nat Rev Clin Oncol Date: 2021-06-30 Impact factor: 66.675
Authors: Kim M Kraus; Julius C Fischer; Kai J Borm; Marco M E Vogel; Steffi U Pigorsch; Michal Devečka; Stephanie E Combs Journal: Sci Rep Date: 2021-04-07 Impact factor: 4.379
Authors: Ingrid Masson; Martine Bellanger; Geneviève Perrocheau; Marc-André Mahé; David Azria; Pascal Pommier; Nathalie Mesgouez-Nebout; Philippe Giraud; Didier Peiffert; Bruno Chauvet; Philippe Dudouet; Naji Salem; Georges Noël; Jonathan Khalifa; Igor Latorzeff; Catherine Guérin-Charbonnel; Stéphane Supiot Journal: Front Oncol Date: 2022-01-11 Impact factor: 6.244