Intensity‐modulated radiotherapy in the treatment of locoregionally advanced head and neck cancer: implementation and outcomes in a New Zealand community hospital
نویسندگان
چکیده
INTRODUCTION Intensity-modulated radiotherapy (IMRT) has become the standard of care for squamous cell cancer of the head and neck (HNSCC). This report presents early outcomes of IMRT with concomitant chemotherapy in a community setting in New Zealand. METHODS Forty-eight patients with stage III and IV advanced HNSCC received definitive treatment with IMRT. A dose of 66 Gy in 30 fractions was delivered over 6 weeks with 3-weekly concurrent cisplatin after a single induction cycle of cisplatin and 5-fluorouracil. Acute toxicity, locoregional control (LRC), disease-free survival and overall survival (OS) outcomes were analysed. RESULTS Follow-up ranged from 2 to 82 months (median 34 months). Acute grade 2 toxicity was observed in 27 patients and grade 3 toxicity in 19 patients. No patients experienced grade 4 toxicity and there were no treatment-related deaths. Locoregional failures occurred in six patients and distant metastatic disease occurred in five patients. Actuarial estimates of 3-year LRC, disease-free survival and OS were 87.3%, 74.4% and 73.7% respectively. CONCLUSION Definitive treatment of stage III and IV cancer of the head and neck with IMRT and concurrent chemotherapy was achievable in the community setting. Acute toxicities were manageable and 3-year outcomes were comparable to other published series.
منابع مشابه
Dose Distribution Analysis of Rapid Arc and Intensity Modulated Radiotherapy Plan in Head and Neck Cancer
Introduction: Globally, intensity-modulated radiation therapy (IMRT) is considered as highly precise and accurate method of radiotherapy planning. This technique amplifies spatial dose distribution conformity by modulating the intensity of radiation beams in each sub-volume. Additionally, it can reduces the dose to surrounding critical organs and deliver the planned dose to targets with the nom...
متن کاملA Review on the Efficacy of Chemotherapy in Locally Advanced Head and Neck Cancers
Background and Aims: Chemotherapy is utilized as a part of combined-modality programs to achieve organ preservation and improve survival in patients with locally advanced head and neck cancer. Combinedmodality protocols can be used in three forms: a) neoadjuvant induction chemotherapy before definitive surgery or radiotherapy; b) concomitant chemoradiotherapy; and c) sequential therapy consisti...
متن کاملPromising new advances in head and neck radiotherapy.
Efforts to improve the efficacy of treatment for SCCHN have led to the use of multimodality approaches with combinations of surgery, radiotherapy and chemotherapy. Conventional head and neck radiotherapy, a standard approach for locoregionally advanced disease, is associated with a variety of well-known acute and long-term toxicities. These chronic toxicities (i.e. xerostomia, dysphagia, fibros...
متن کاملLocoregionally advanced nasopharyngeal carcinoma in childhood and adolescence: Analysis of 95 patients treated with combined chemotherapy and intensity-modulated radiotherapy.
BACKGROUND The purpose of this study was to evaluate the treatment outcomes and toxicities of intensity-modulated radiation therapy (IMRT) for children and adolescents with locoregionally advanced nasopharyngeal carcinoma (NPC). METHODS Ninety-five patients of <25 years old in locoregionally advanced NPC (stage III-IVB) were analyzed. All were given neoadjuvant chemotherapy followed by IMRT w...
متن کاملSevere cutaneous toxicity following treatment with radiotherapy and cetuximab: a case report
While the addition of cetuximab to radiotherapy improves clinical outcomes in locoregionally advanced head and neck squamous cell cancers, there are a small number of reports of severe radiation dermatitis occurring with this therapeutic combination. We present the case of a 69 year old male who developed severe radiation dermatitis following treatment with cetuximab and radiotherapy for a loco...
متن کامل