J Castelli1,2,3, A Simon2,3, C Lafond1,2,3, N Perichon1, B Rigaud2,3, E Chajon1, B De Bari4, M Ozsahin5, J Bourhis5, R de Crevoisier1,2,3. 1. a Radiotherapy Department , Centre Eugene Marquis , Rennes , France. 2. b INSERM U1099 LTSI , Rennes , France. 3. c Université de Rennes 1 , Rennes , France. 4. d Radiotherapy Department , CHU Jean-Minjoz , Besançon , France. 5. e Radiotherapy Department , Lausanne University Hospital , Lausanne , Switzerland.
Abstract
INTRODUCTION: Large anatomical variations can be observed during the treatment course intensity-modulated radiotherapy (IMRT) for head and neck cancer (HNC), leading to potential dose variations. Adaptive radiotherapy (ART) uses one or several replanning sessions to correct these variations and thus optimize the delivered dose distribution to the daily anatomy of the patient. This review, which is focused on ART in the HNC, aims to identify the various strategies of ART and to estimate the dosimetric and clinical benefits of these strategies. MATERIAL AND METHODS: We performed an electronic search of articles published in PubMed/MEDLINE and Science Direct from January 2005 to December 2016. Among a total of 134 articles assessed for eligibility, 29 articles were ultimately retained for the review. Eighteen studies evaluated dosimetric variations without ART, and 11 studies reported the benefits of ART. RESULTS: Eight in silico studies tested a number of replanning sessions, ranging from 1 to 6, aiming primarily to reduce the dose to the parotid glands. The optimal timing for replanning appears to be early during the first two weeks of treatment. Compared to standard IMRT, ART decreases the mean dose to the parotid gland from 0.6 to 6 Gy and the maximum dose to the spinal cord from 0.1 to 4 Gy while improving target coverage and homogeneity in most studies. Only five studies reported the clinical results of ART, and three of those studies included a non-randomized comparison with standard IMRT. These studies suggest a benefit of ART in regard to decreasing xerostomia, increasing quality of life, and increasing local control. Patients with the largest early anatomical and dose variations are the best candidates for ART. CONCLUSION: ART may decrease toxicity and improve local control for locally advanced HNC. However, randomized trials are necessary to demonstrate the benefit of ART before using the technique in routine practice.
INTRODUCTION: Large anatomical variations can be observed during the treatment course intensity-modulated radiotherapy (IMRT) for head and neck cancer (HNC), leading to potential dose variations. Adaptive radiotherapy (ART) uses one or several replanning sessions to correct these variations and thus optimize the delivered dose distribution to the daily anatomy of the patient. This review, which is focused on ART in the HNC, aims to identify the various strategies of ART and to estimate the dosimetric and clinical benefits of these strategies. MATERIAL AND METHODS: We performed an electronic search of articles published in PubMed/MEDLINE and Science Direct from January 2005 to December 2016. Among a total of 134 articles assessed for eligibility, 29 articles were ultimately retained for the review. Eighteen studies evaluated dosimetric variations without ART, and 11 studies reported the benefits of ART. RESULTS: Eight in silico studies tested a number of replanning sessions, ranging from 1 to 6, aiming primarily to reduce the dose to the parotid glands. The optimal timing for replanning appears to be early during the first two weeks of treatment. Compared to standard IMRT, ART decreases the mean dose to the parotid gland from 0.6 to 6 Gy and the maximum dose to the spinal cord from 0.1 to 4 Gy while improving target coverage and homogeneity in most studies. Only five studies reported the clinical results of ART, and three of those studies included a non-randomized comparison with standard IMRT. These studies suggest a benefit of ART in regard to decreasing xerostomia, increasing quality of life, and increasing local control. Patients with the largest early anatomical and dose variations are the best candidates for ART. CONCLUSION:ART may decrease toxicity and improve local control for locally advanced HNC. However, randomized trials are necessary to demonstrate the benefit of ART before using the technique in routine practice.
Authors: Brigid A McDonald; Sastry Vedam; Jinzhong Yang; Jihong Wang; Pamela Castillo; Belinda Lee; Angela Sobremonte; Sara Ahmed; Yao Ding; Abdallah S R Mohamed; Peter Balter; Neil Hughes; Daniela Thorwarth; Marcel Nachbar; Marielle E P Philippens; Chris H J Terhaard; Daniel Zips; Simon Böke; Musaddiq J Awan; John Christodouleas; Clifton D Fuller Journal: Int J Radiat Oncol Biol Phys Date: 2020-12-16 Impact factor: 7.038
Authors: Lars Bielak; Nicole Wiedenmann; Nils Henrik Nicolay; Thomas Lottner; Johannes Fischer; Hatice Bunea; Anca-Ligia Grosu; Michael Bock Journal: Tomography Date: 2019-09
Authors: Suzanne van Beek; Marcel Jonker; Olga Hamming-Vrieze; Abrahim Al-Mamgani; Arash Navran; Peter Remeijer; Jeroen B van de Kamer Journal: Tech Innov Patient Support Radiat Oncol Date: 2019-12-16