Intraoperative electron beam radiotherapy for locoregionally persistent or recurrent head and neck cancer
| Autor: | Aashish D. Bhatt, Steve Walston, James W. Rocco, Patrick Wald, Theodoros N. Teknos, Matthew O. Old, Marcelo Bonomi, Douglas Martin, Dukagjin Blakaj, Lai Wei, John C. Grecula |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Surgical margin medicine.medical_specialty medicine.medical_treatment Electrons Disease-Free Survival 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Adjuvant therapy Humans Medicine External beam radiotherapy Intraoperative radiation therapy Aged Retrospective Studies Aged 80 and over Salvage Therapy Univariate analysis Intraoperative Care business.industry Head and neck cancer Margins of Excision Histology Middle Aged medicine.disease Otorhinolaryngology Head and Neck Neoplasms 030220 oncology & carcinogenesis Toxicity Carcinoma Squamous Cell Female Radiotherapy Adjuvant Radiology Neoplasm Recurrence Local business Follow-Up Studies |
| Zdroj: | Head & Neck. 41:2148-2153 |
| ISSN: | 1097-0347 1043-3074 |
| Popis: | Background To report our institutional experience with intraoperative radiotherapy for persistent or recurrent head and neck cancer. Methods Sixty-one patients were treated with salvage surgery and intraoperative radiation therapy (IORT). Fifty-eight patients (95%) had previously received external beam radiotherapy (EBRT) as a component of their definitive therapy. Forty-four patients (72%) had squamous cell carcinoma (SCC). Surgical margins were positive in 28 patients (46%). IORT was prescribed to a median dose of 12.5 Gy (range, 10-17.5). Twenty-three patients (38%) received a course of postoperative EBRT (median 45 Gy). Clinical outcomes were retrospectively reviewed and univariate analysis was performed using log-rank tests to correlate clinical outcomes with histology, surgical margin, and adjuvant therapy. Results Median follow-up among surviving patients was 15.9 months. Median progression-free survival (PFS) and overall survival (OS) were 9.8 and 19.1 months, respectively. One- and 2-year rates of locoregional control (LRC) were 59% and 35%, respectively. One- and 2-year rates of PFS were 39% and 19%, respectively. One- and 2-year rates of OS were 62% and 42%, respectively. Overall survival was better for non-SCC histology (P = .03). For SCC patients, negative surgical margin showed a trend toward improved PFS (P = .09) and OS (P = .06). There was one grade-5 toxicity due to carotid rupture. Conclusions IORT has shown effective LRC and OS with an acceptably low rate of severe toxicity at our institution. OS was significantly better for non-SCC histology. For SCC patients, there is a trend toward improved PFS and OS associated with negative surgical margins. |
| Databáze: | OpenAIRE |
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