A feasibility study on adaptive

Autor: Julie, Schatteman, Dirk, Van Gestel, Dieter, Berwouts, Werner, De Gersem, Geert, De Kerf, Wilfried, De Neve, Bie, De Ost, Ana Maria Luiza, Olteanu, Sylvie, Rottey, Tom, Vercauteren, Ingeborg, Goethals, Fréderic, Duprez
Rok vydání: 2017
Předmět:
Zdroj: Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al]. 194(8)
ISSN: 1439-099X
Popis: To evaluate feasibility, disease control, survival, and toxicity after adaptiveA prospective trial investigated the feasibility of adaptive intensity modulated radiotherapy (IMRT) ± concomitant cetuximab in 10 patients. The primary endpoint was achieving a 2-year survival free of grade3 toxicity in ≥30% of patients. Three treatment plans based on 3 PET/CT scans were consecutively delivered in 6 weeks. The range of dose painting was 66.0-85.0 Gy in the dose-painted tumoral volumes in 30 fractions.Two-year locoregional and distant control rates were 38 and 76%, respectively. Overall and disease-free survival at 2 years was 20%. No grade 4 or 5 acute toxicity was observed in any of the patients, except for arterial mucosal hemorrhage in 1 patient. Three months after radiotherapy, grade 4 dysphagia and mucosal wound healing problems were observed in 1/7 and 1/6 of patients, respectively. Grade 5 toxicity (fatal bleeding) was seen in 2 patients, at 3.8 and 4.1 months of follow-up. Data on 2‑year toxicity could only be assessed in 1 of the 2 surviving patients, in whom grade 4 mucosal wound healing problems were observed; no other grade3 toxicity was observed. In this respect, a 30% 2‑year survival free of grade3 toxicity will not be achieved.Adaptive PET-guided reirradiation is feasible. However, due to slow accrual and treatment results that seemed inconsistent with achieving the primary endpoint, the trial was stopped early.
Databáze: OpenAIRE
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