Reduction of GTV to high-risk CTV radiation margin in head and neck squamous cell carcinoma significantly reduced acute and late radiation-related toxicity with comparable outcomes
| Autor: | Tomas Janssen, Marcel C.J. Jonker, Corrie A.M. Marijnen, Rob Kessels, Charlotte L. Zuur, Arash Navran, Jan-Jakob Sonke, Jan de Boer, Olga Hamming-Vrieze, Abrahim Al-Mamgani |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment VMAT HNSCC Late toxicity Margin (machine learning) medicine Humans Arc therapy Radiology Nuclear Medicine and imaging Head and neck cancer Reduction (orthopedic surgery) Retrospective Studies Toxicity Squamous Cell Carcinoma of Head and Neck business.industry Incidence (epidemiology) Radiotherapy Dosage GTV-CTV margin reduction Hematology medicine.disease Head and neck squamous-cell carcinoma Oncology Head and Neck Neoplasms Radiotherapy Intensity-Modulated Radiology business |
| Zdroj: | Radiotherapy and Oncology, 162, 170-177. ELSEVIER IRELAND LTD |
| ISSN: | 0167-8140 |
| DOI: | 10.1016/j.radonc.2021.07.016 |
| Popis: | Background and purpose: We aim to retrospectively investigate whether reducing GTV to high-risk CTV margin will significantly reduce acute and late toxicity without jeopardizing outcome in head-and neck squamous cell carcinoma (HNSCC) treated with definitive (chemo)radiation. Materials and methods: Between April 2015 and April 2019, 155 consecutive patients were treated with GTV to high-risk CTV margin of 10 mm and subsequently another 155 patients with 6 mm margin. The CTV-PTV margin was 3 mm for both groups. All patients were treated with volumetric-modulated arc therapy with daily image-guidance using cone-beam CT. End points of the study were acute and late toxicity and oncologic outcomes. Results: Overall acute grade 3 toxicity was significantly lower in 6 mm, compared to 10 mm group (48% vs. 67%, respectively, p < 0.01). The same was true for acute grade 3 mucositis (18% vs. 34%, p < 0.01) and grade > 2 dysphagia (67% vs. 85%, p < 0.01). Also feeding tube-dependency at the end of treatment (25% vs. 37%, p = 0.02), at 3 months (12% and 25%, p < 0.01), and at 6 months (6% and 15%, p = 0.01) was significantly less in 6 mm group. The incidence of late grade 2 xerostomia was also significantly lower in the 6 mm group (32% vs. 50%, p < 0.01). The 2-year rates of loco-regional control, disease-free and overall survival were 78.7% vs. 73.1%, 70.6% vs. 61.4%, and 83.2% vs. 74.4% (p > 0.05, all). Conclusion: The first study reporting on reduction of GTV to high-risk CTV margin from 10 to 6 mm showed significant reduction of the incidence and severity of radiation-related toxicity without reducing local-regional control and survival. (c) 2021 Elsevier B.V. All rights reserved. Radiotherapy and Oncology 162 (2021) 170-177 |
| Databáze: | OpenAIRE |
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