Prospective assessment of patterns of failure after high-precision definitive (chemo)radiation in head-and-neck squamous cell carcinoma

International Journal of Radiation Oncology, Biology, Physics
Tejpal GuptaKetayun A Dinshaw

Abstract

To prospectively analyze patterns of failure in patients with head-and-neck squamous cell carcinoma treated with definitive high-precision radiotherapy with a focus on location of failure relative to target volume coverage. Sixty patients treated with three-dimensional conformal radiotherapy or intensity-modulated radiation therapy were included. Locoregional failure volume was defined on the planning data set at relapse, and dose received was analyzed by use of dose-volume histograms. Thirteen patients were deemed to have had locoregional failures, of which two did not have any viable tumor on salvage neck dissection, leaving eleven patients with proven persistent or recurrent locoregional disease. Of these, 9 patients had in-field failure, 1 marginal failure, and 1 both in-field and marginal failures. Overall, only 2 of 11 patients (18%) with relapse had any marginal failure. Of the 20 sites of locoregional failure, 15 (75%) were in-field and 5 (25%) marginal. Distant metastases were detected in 3 patients, whereas a second new primary developed in 3 others. With a median follow-up of 26 months (interquartile range, 18-31 months) for surviving patients, the 3-year local control, locoregional control, disease-free survival, an...Continue Reading

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Citations

Mar 15, 2016·International Journal of Radiation Oncology, Biology, Physics·Julie KjemsJeppe Friborg
Aug 3, 2012·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Tejpal GuptaAnil D'Cruz
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Apr 19, 2015·Radiation Oncology·Brigida Costa FerreiraMaria do Carmo Lopes
Dec 18, 2013·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Gustavo Nader MartaRachel Riera
Jan 22, 2013·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Kyle WangBarton F Branstetter
Jun 1, 2013·The Oncologist·Dirk Van GestelVincent Gregoire

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