Impact of upgraded radiotherapy system on outcomes in postoperative head and neck squamous cell carcinoma patients.

Background: This study was performed to evaluate the impact of upgrade of radiotherapy system, including launch of intensity-modulated radiation therapy (IMRT), on the therapeutic outcomes. Materials and methods: Patients with head and neck (H&N) squamous cell carcinoma (SCC) who underwent postoperative radiotherapy at our hospital between June 2009 and July 2019 were retrospectively reviewed. In July 2014, we converted the radiotherapy technique for these patients from a 3-dimensional conformal radiotherapy (3D-CRT) to IMRT, along with the adoption of a meticulous planning policy and a few advanced procedures, including online imaging guidance. Results: A total of 136 patients (57 treated with the previous system and 79 treated with the upgraded system) were reviewed. There were significantly more patients with extracapsular extension in the upgraded-system group than the previous-system group (p = 0.0021). There were significantly fewer patients with ≥ Grade 2 acute and late adverse events in the upgraded-system group than the previous-system group. The differences in progression-free survival (PFS), distant metastasis-free survival (DFFS), locoregional progression-free survival (LRPFS), and overall survival (OS) between the two groups were not statistically significant (p = 0.8962, 0.9926, 0.6244, and 0.4827, respectively). Multivariate analysis revealed that the upgrade had neither positive nor negative impact on survival outcomes. Extracapsular extension was independently associated with decreased LRPFS and OS (p = 0.0499 and 0.0392, respectively). Conclusions: The IMRT-centered upgrade was beneficial for the postoperative patients with H&N SCC, because survival outcomes were sustained with less toxicities.

Ten-Year Experience of Stereotactic Body Radiotherapy at a Single Institution: Impact of Technological Development on the Outcome of Patients With Early Lung Cancer.

PURPOSE: Advanced radiotherapeutic techniques and apparatus have been developed and widely applied in stereotactic body radiation therapy for early-stage non-small cell lung cancer, but their clinical benefits have not necessarily been confirmed. This study was performed to review our 10-year experience with therapy for the disease and to evaluate whether the advanced radiotherapeutic system implemented in our hospital 5 years after we began the therapy improved the clinical outcomes of patients. MATERIALS AND METHODS: Patients who underwent the therapy at our hospital between April 2008 and March 2018 were retrospectively reviewed. They were divided into 2 groups treated with the conventional system or the advanced system, and the characteristics and clinical outcomes were compared between the groups. The same analyses were also performed in propensity-matched patients from the 2 groups. RESULTS: Among the 73 patients eligible for this study, 42 were treated with the conventional system and 31 with the advanced system. All were treated as planned, and severe adverse events were rare. The local progression-free survival rate in the advanced system group was significantly higher than in the conventional system group (P = 0.025). In the propensity-matched patients, both the local progression-free survival rate and the overall survival rate were significantly higher compared in the advanced system group than the conventional system group (P = 0.089 and 0.080, respectively). CONCLUSION: The advanced system improved the outcomes of patients with the disease, suggesting that technological development has had a strong impact on clinical outcomes.