AIM: To evaluate early outcome of simultaneous integrated boost (SIB) on PET positive sub-volume (Biological Target Volume BTV) intensity-modulated radiotherapy (BTV-SIB-IMRT) in Head and Neck cancer (HNC) patients. MATERIALS and METHODS: Forty-eight HNC patients (36 men, 12 women, mean age 58 yrs, range 23-81; 35.4% I-II-III pTNM stages (I (4.2%), II (12.5%), and III (18.7%)) and 64.6% IV pTNM stage disease; local extension T1-T2 in 58.3% and T3-T4 in 41.7%; tumor site oropharynx in 43.7% and rinopharynx 39.6% , 16.7% other; 56.2% squamocellular and 37.5% undifferentiated carcinoma, 6.2% other) treated by BTV-SIB-IMRT between 2005 and 2011 at dose of 69 Gy, 30 fractions, were retrospectively included in the study. Two-year disease-free (DFS), local relapse-free (LRFS) and distant metastases-free survival (DMFS) were calculated and correlated to tumor stage, local extension, site and histology. RESULTS: On stage based analysis (I-II vs III-IV) DFS, LRFS and DMFS were 88, 88 and 100% vs 55, 63 and 76%; while comparing I-II-III vs IV the figures were 88, 88 and 94% vs 45 (p<0.01), 55 (p<0.05) and 73%. On local extension based analysis (T1-T2 vs T3-T4) the figures were 75, 82 and 93% vs 40 (p<0.01), 48 (p<0.025), and 64% (p<0.025). On site based analysis (oropharynx vs rinopharynx) the figures were 81%, 81% and 100% vs 58%, 68% and 68% (p<0.01). On hystotype based analysis (squamous cell vs undifferentiated) the figures were 67%, 74% and 89% vs 53%, 63% and 71%. CONCLUSIONS: BTV-SIB-IMRT demonstrated to be a feasible technique. In our series it allows local and overall disease control in stage III patients similar to that in stage I-II patients. A larger population of patients and a longer follow-up period are needed to evaluate ultimate tumor control and toxicity, to be compared to those of standard radiation treatment approach.
18FDG PET/CT Image-Guided Simultaneous Integrated Boost Intensity-Modulated Radiotherapy in Head and Neck cancer
Isabella Castiglioni;Maria Picchio;Cristina Messa
2012
Abstract
AIM: To evaluate early outcome of simultaneous integrated boost (SIB) on PET positive sub-volume (Biological Target Volume BTV) intensity-modulated radiotherapy (BTV-SIB-IMRT) in Head and Neck cancer (HNC) patients. MATERIALS and METHODS: Forty-eight HNC patients (36 men, 12 women, mean age 58 yrs, range 23-81; 35.4% I-II-III pTNM stages (I (4.2%), II (12.5%), and III (18.7%)) and 64.6% IV pTNM stage disease; local extension T1-T2 in 58.3% and T3-T4 in 41.7%; tumor site oropharynx in 43.7% and rinopharynx 39.6% , 16.7% other; 56.2% squamocellular and 37.5% undifferentiated carcinoma, 6.2% other) treated by BTV-SIB-IMRT between 2005 and 2011 at dose of 69 Gy, 30 fractions, were retrospectively included in the study. Two-year disease-free (DFS), local relapse-free (LRFS) and distant metastases-free survival (DMFS) were calculated and correlated to tumor stage, local extension, site and histology. RESULTS: On stage based analysis (I-II vs III-IV) DFS, LRFS and DMFS were 88, 88 and 100% vs 55, 63 and 76%; while comparing I-II-III vs IV the figures were 88, 88 and 94% vs 45 (p<0.01), 55 (p<0.05) and 73%. On local extension based analysis (T1-T2 vs T3-T4) the figures were 75, 82 and 93% vs 40 (p<0.01), 48 (p<0.025), and 64% (p<0.025). On site based analysis (oropharynx vs rinopharynx) the figures were 81%, 81% and 100% vs 58%, 68% and 68% (p<0.01). On hystotype based analysis (squamous cell vs undifferentiated) the figures were 67%, 74% and 89% vs 53%, 63% and 71%. CONCLUSIONS: BTV-SIB-IMRT demonstrated to be a feasible technique. In our series it allows local and overall disease control in stage III patients similar to that in stage I-II patients. A larger population of patients and a longer follow-up period are needed to evaluate ultimate tumor control and toxicity, to be compared to those of standard radiation treatment approach.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
