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Adaptive radiotherapy benefited patients with head and neck cancers
Schwartz DL. Int J Radiat Oncol Biol Phys. 2011;doi:10.1016/j.ijrobp.2011.08.017.
Adaptive radiotherapy was associated with nearly perfect disease control outcomes in a cohort of patients with head and neck cancers, according to study results.
The aim of the trial was to present pilot toxicity and survival outcomes for a prospective trial investigating adaptive radiotherapy as a treatment for oropharyngeal squamous cell carcinoma in 24 patients.
The final analysis involved data for 22 patients, 20 of whom had American Joint Committee on Cancer stage IV disease.
The primary site was base of tongue in 15 patients. Six patients had disease in the tonsil and one patient had a primary site of the glossopharyngeal sulcus. The researchers said the T stage distribution was 2 T1, 12 T2, 3 T3 and 5 T4, and the N stage distribution was 1 N0, 2 N1, 5 N2a, 12 N2b and 2 N2c.
Twenty-one patients received systemic therapy.
The median follow-up duration was 31 months (range, 13-45 months). No primary site failures and only one nodal relapse were observed. This resulted in 100% local and 95% regional disease control at the 2-year mark.
An association between baseline tumor size and absolute volumetric treatment response was observed (P=.018). Similarly, an association between parotid volumetric change and duration of feeding tube placement also was reported (P=.025).
The acute toxicity of adaptive radiotherapy was comparable with that associated with conventional intensity-modulated radiotherapy.
“This is the first prospective evaluation of morbidity and survival outcomes in patients with locally advanced head and neck cancers treated with automated adaptive replanning,” the researchers wrote.
They suggested that adaptive radiotherapy may provide dosimetric benefit with few mid-treatment replanning events.
“Our preliminary clinical outcomes document functional recovery and preservation of disease control at 1-year follow-up and beyond,” the researchers wrote.