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Van Gestel D, Van den Weyngaert D, De Kerf G, De Ost B, Vanderveken O, Van Laer C, Specenier P, Geussens Y, Wouters K, Meulemans E, Cheung KJ, Grégoire V, Vermorken JB. Helical tomotherapy in head and neck cancer: a European single-center experience. Oncologist 2015; 20:279-90. [PMID: 25673104 PMCID: PMC4350799 DOI: 10.1634/theoncologist.2014-0337] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Accepted: 12/18/2014] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND We report on a retrospective analysis of 147 patients with early and locoregionally advanced squamous cell head and neck cancer (SCCHN) treated with helical tomotherapy (HT). PATIENTS AND METHODS Included were patients with SCCHN of the oral cavity (OC), oropharynx (OP), hypopharynx (HP), or larynx (L) consecutively treated in one radiotherapy center in 2008 and 2009. The prescribed HT dose was 60-66 Gy in the postoperative setting (group A) and 66-70 Gy when given as primary treatment (group B). HT was given alone, concurrent with systemic therapy (ST), that is, chemotherapy, biotherapy, or both, and with or without induction therapy (IT). Acute and late toxicities are reported using standard criteria; locoregional failure/progression (LRF), distant metastases (DM), and second primary tumors (SPT) were documented, and event-free survival (EFS) and overall survival (OS) were calculated from the start of HT. RESULTS Group A patients received HT alone in 22 cases and HT + ST in 20 cases; group B patients received HT alone in 17 cases and HT + ST in 88 cases. Severe (grade ≥ 3) acute mucosal toxicity and swallowing problems increased with more additional ST. After a median follow-up of 44 months, grade ≥2 late toxicity after HT + ST was approximately twice that of HT alone for skin, subcutis, pharynx, and larynx. Forty percent had grade ≥2 late xerostomia, and 29% had mucosal toxicity. At 3 years, LRF/DM/SPT occurred in 7%/7%/17% and 25%/13%/5% in groups A and B, respectively, leading to a 3-year EFS/OS of 64%/74% and 56%/63% in groups A and B, respectively. CONCLUSION The use of HT alone or in combination with ST is feasible and promising and has a low late fatality rate. However, late toxicity is nearly twice as high when ST is added to HT.
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Affiliation(s)
- Dirk Van Gestel
- Department of Radiotherapy, University Radiotherapy Antwerp UZA/ZNA, Antwerp, Belgium; Department of Otolaryngology and Head and Neck Surgery, Department of Medical Oncology, Scientific Coordination and Biostatistics, and Data-Management Multidisciplinair Oncologisch Centrum Antwerpen, Antwerp University Hospital, Edegem, Belgium; Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Iridium Kankernetwerk, Campus Nikolaas, Sint Niklaas, Belgium; Radiation Oncology Department and Centre for Molecular Imaging and Experimental Radiotherapy, St-Luc University Hospital, Brussels, Belgium
| | - Danielle Van den Weyngaert
- Department of Radiotherapy, University Radiotherapy Antwerp UZA/ZNA, Antwerp, Belgium; Department of Otolaryngology and Head and Neck Surgery, Department of Medical Oncology, Scientific Coordination and Biostatistics, and Data-Management Multidisciplinair Oncologisch Centrum Antwerpen, Antwerp University Hospital, Edegem, Belgium; Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Iridium Kankernetwerk, Campus Nikolaas, Sint Niklaas, Belgium; Radiation Oncology Department and Centre for Molecular Imaging and Experimental Radiotherapy, St-Luc University Hospital, Brussels, Belgium
| | - Geert De Kerf
- Department of Radiotherapy, University Radiotherapy Antwerp UZA/ZNA, Antwerp, Belgium; Department of Otolaryngology and Head and Neck Surgery, Department of Medical Oncology, Scientific Coordination and Biostatistics, and Data-Management Multidisciplinair Oncologisch Centrum Antwerpen, Antwerp University Hospital, Edegem, Belgium; Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Iridium Kankernetwerk, Campus Nikolaas, Sint Niklaas, Belgium; Radiation Oncology Department and Centre for Molecular Imaging and Experimental Radiotherapy, St-Luc University Hospital, Brussels, Belgium
| | - Bie De Ost
- Department of Radiotherapy, University Radiotherapy Antwerp UZA/ZNA, Antwerp, Belgium; Department of Otolaryngology and Head and Neck Surgery, Department of Medical Oncology, Scientific Coordination and Biostatistics, and Data-Management Multidisciplinair Oncologisch Centrum Antwerpen, Antwerp University Hospital, Edegem, Belgium; Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Iridium Kankernetwerk, Campus Nikolaas, Sint Niklaas, Belgium; Radiation Oncology Department and Centre for Molecular Imaging and Experimental Radiotherapy, St-Luc University Hospital, Brussels, Belgium
| | - Olivier Vanderveken
- Department of Radiotherapy, University Radiotherapy Antwerp UZA/ZNA, Antwerp, Belgium; Department of Otolaryngology and Head and Neck Surgery, Department of Medical Oncology, Scientific Coordination and Biostatistics, and Data-Management Multidisciplinair Oncologisch Centrum Antwerpen, Antwerp University Hospital, Edegem, Belgium; Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Iridium Kankernetwerk, Campus Nikolaas, Sint Niklaas, Belgium; Radiation Oncology Department and Centre for Molecular Imaging and Experimental Radiotherapy, St-Luc University Hospital, Brussels, Belgium
| | - Carl Van Laer
- Department of Radiotherapy, University Radiotherapy Antwerp UZA/ZNA, Antwerp, Belgium; Department of Otolaryngology and Head and Neck Surgery, Department of Medical Oncology, Scientific Coordination and Biostatistics, and Data-Management Multidisciplinair Oncologisch Centrum Antwerpen, Antwerp University Hospital, Edegem, Belgium; Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Iridium Kankernetwerk, Campus Nikolaas, Sint Niklaas, Belgium; Radiation Oncology Department and Centre for Molecular Imaging and Experimental Radiotherapy, St-Luc University Hospital, Brussels, Belgium
| | - Pol Specenier
- Department of Radiotherapy, University Radiotherapy Antwerp UZA/ZNA, Antwerp, Belgium; Department of Otolaryngology and Head and Neck Surgery, Department of Medical Oncology, Scientific Coordination and Biostatistics, and Data-Management Multidisciplinair Oncologisch Centrum Antwerpen, Antwerp University Hospital, Edegem, Belgium; Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Iridium Kankernetwerk, Campus Nikolaas, Sint Niklaas, Belgium; Radiation Oncology Department and Centre for Molecular Imaging and Experimental Radiotherapy, St-Luc University Hospital, Brussels, Belgium
| | - Yasmyne Geussens
- Department of Radiotherapy, University Radiotherapy Antwerp UZA/ZNA, Antwerp, Belgium; Department of Otolaryngology and Head and Neck Surgery, Department of Medical Oncology, Scientific Coordination and Biostatistics, and Data-Management Multidisciplinair Oncologisch Centrum Antwerpen, Antwerp University Hospital, Edegem, Belgium; Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Iridium Kankernetwerk, Campus Nikolaas, Sint Niklaas, Belgium; Radiation Oncology Department and Centre for Molecular Imaging and Experimental Radiotherapy, St-Luc University Hospital, Brussels, Belgium
| | - Kristien Wouters
- Department of Radiotherapy, University Radiotherapy Antwerp UZA/ZNA, Antwerp, Belgium; Department of Otolaryngology and Head and Neck Surgery, Department of Medical Oncology, Scientific Coordination and Biostatistics, and Data-Management Multidisciplinair Oncologisch Centrum Antwerpen, Antwerp University Hospital, Edegem, Belgium; Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Iridium Kankernetwerk, Campus Nikolaas, Sint Niklaas, Belgium; Radiation Oncology Department and Centre for Molecular Imaging and Experimental Radiotherapy, St-Luc University Hospital, Brussels, Belgium
| | - Els Meulemans
- Department of Radiotherapy, University Radiotherapy Antwerp UZA/ZNA, Antwerp, Belgium; Department of Otolaryngology and Head and Neck Surgery, Department of Medical Oncology, Scientific Coordination and Biostatistics, and Data-Management Multidisciplinair Oncologisch Centrum Antwerpen, Antwerp University Hospital, Edegem, Belgium; Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Iridium Kankernetwerk, Campus Nikolaas, Sint Niklaas, Belgium; Radiation Oncology Department and Centre for Molecular Imaging and Experimental Radiotherapy, St-Luc University Hospital, Brussels, Belgium
| | - Kin Jip Cheung
- Department of Radiotherapy, University Radiotherapy Antwerp UZA/ZNA, Antwerp, Belgium; Department of Otolaryngology and Head and Neck Surgery, Department of Medical Oncology, Scientific Coordination and Biostatistics, and Data-Management Multidisciplinair Oncologisch Centrum Antwerpen, Antwerp University Hospital, Edegem, Belgium; Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Iridium Kankernetwerk, Campus Nikolaas, Sint Niklaas, Belgium; Radiation Oncology Department and Centre for Molecular Imaging and Experimental Radiotherapy, St-Luc University Hospital, Brussels, Belgium
| | - Vincent Grégoire
- Department of Radiotherapy, University Radiotherapy Antwerp UZA/ZNA, Antwerp, Belgium; Department of Otolaryngology and Head and Neck Surgery, Department of Medical Oncology, Scientific Coordination and Biostatistics, and Data-Management Multidisciplinair Oncologisch Centrum Antwerpen, Antwerp University Hospital, Edegem, Belgium; Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Iridium Kankernetwerk, Campus Nikolaas, Sint Niklaas, Belgium; Radiation Oncology Department and Centre for Molecular Imaging and Experimental Radiotherapy, St-Luc University Hospital, Brussels, Belgium
| | - Jan B Vermorken
- Department of Radiotherapy, University Radiotherapy Antwerp UZA/ZNA, Antwerp, Belgium; Department of Otolaryngology and Head and Neck Surgery, Department of Medical Oncology, Scientific Coordination and Biostatistics, and Data-Management Multidisciplinair Oncologisch Centrum Antwerpen, Antwerp University Hospital, Edegem, Belgium; Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Iridium Kankernetwerk, Campus Nikolaas, Sint Niklaas, Belgium; Radiation Oncology Department and Centre for Molecular Imaging and Experimental Radiotherapy, St-Luc University Hospital, Brussels, Belgium
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