1. Prospective Pilot Study Comparing the Need for Adaptive Radiotherapy in Unresected Bulky Disease and in Postoperative Patients With Head and Neck Cancer
- Author
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Magda Moustafa, Isildinha M. Reis, Elizabeth Bossart, Cristiane Takita, Ehsan El-Ghoneimy, Michael M. Samuels, Nagy Elsayyad, Omar Mahmoud, Mohamed AbdAllah, and Joseph Both
- Subjects
Cancer Research ,medicine.medical_specialty ,medicine.medical_treatment ,definitive chemoradiotherapy ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Unresected ,Medicine ,In patient ,Adaptive radiotherapy ,Stage (cooking) ,Chemotherapy ,business.industry ,Bulky Disease ,Head and neck cancer ,dosimetric ,Original Articles ,medicine.disease ,Surgery ,Radiation therapy ,adaptive radiotherapy ,Oncology ,030220 oncology & carcinogenesis ,head and neck cancer ,postoperative chemoradiotherapy ,Radiology ,business - Abstract
Background: Adaptive radiotherapy is being used in few institutions in patients with head and neck cancer having bulky disease using periodic computed tomography imaging accounting for volumetric changes in tumor volume and/or weight loss. Limited data are available on ART in the postoperative setting. We aim to identify parameters that would predict the need for ART in patients with head and neck cancer and whether ART should be applied in postoperative setting. Materials and Methods: Twenty patients with stage III–IV head and neck cancer were prospectively accrued. A computed tomography simulation was done prior to treatment and repeated at weeks 3 and 6 of concurrent intensity-modulated radiotherapy and chemotherapy. The final plan was coregistered with the subsequent computed tomography images, and dosimetric/volumetric changes at weeks 1 (baseline), 3, and 6 were quantified in high-risk clinical target volumes, low-risk clinical target volumes , right parotid , left parotid , and spinal cord . An event to trigger ART was defined as spinal cord maximum dose >45 Gy, parotid mean dose >26 Gy, and clinical target volume coverage
- Published
- 2017