ABSTRACT
PURPOSE: To report on patterns of relapse following implementation of intensity-modulated radiotherapy and subsequent changes in practice in a tertiary care centre. PATIENTS AND METHODS: Between 2008 and 2011, 188 consecutive patients (mean age 59 years old) received intensity-modulated radiotherapies with curative intent for squamous cell carcinomas of the oral cavity (17.5%), oropharynx (43%), hypopharynx (21%), larynx (14%), sinonasal cavities (6%), nasopharynx (1.5%) at the university hospital of Besançon. There were stage I and II 9%, III 24.5%, IV 66.5%. One hundred and thirty-eight underwent exclusive intensity-modulated radiotherapy, 50 underwent postoperative intensity-modulated radiotherapy, 174 had concurrent chemotherapy, 57 had induction chemotherapy. Dynamic intensity-modulated radiotherapy with static fields was performed for all patients using sequential irradiation in 174 patients and simultaneous integrated boost irradiation in 14 patients. RESULTS: With a median follow-up was 27.5 months, there was 79% of locoregional failures occurred in the 95% isodose. Two-year overall survival, disease-free, local failure-free and locoregional failure-free survival rates were73%, 60%, 79% and 72%, respectively. Prognostic factors for disease-free survival were stage (IV vs. I-III) with a relative risk of 1.7 [1.1-2.8] (P=0.02) and T stage with 1.6 [1.04-2.5] (P=0.03). CONCLUSION: The current series showed similar patterns of failure as in other tertiary care centres. We did not identify intensity-modulated radiotherapy specific relapse risks.
Subject(s)
Carcinoma, Squamous Cell/radiotherapy , Head and Neck Neoplasms/radiotherapy , Radiotherapy, Intensity-Modulated , Adult , Aged , Aged, 80 and over , Antineoplastic Agents/therapeutic use , Carcinoma, Squamous Cell/drug therapy , Carcinoma, Squamous Cell/mortality , Carcinoma, Squamous Cell/surgery , Combined Modality Therapy , Disease-Free Survival , Female , France/epidemiology , Head and Neck Neoplasms/drug therapy , Head and Neck Neoplasms/mortality , Head and Neck Neoplasms/surgery , Humans , Kaplan-Meier Estimate , Male , Middle Aged , Neoplasm Recurrence, Local/diagnostic imaging , Neoplasm Recurrence, Local/epidemiology , Prognosis , Radiation Injuries/epidemiology , Radiation Injuries/etiology , Radiotherapy Dosage , Radiotherapy, Intensity-Modulated/adverse effects , Retrospective Studies , Tertiary Care CentersABSTRACT
Indication, doses, technique of radiotherapy and concomitant chemotherapy for oropharynx carcinoma are presented. The recommendations for delineation of the target volumes and organs at risk are detailed.
Subject(s)
Carcinoma/radiotherapy , Oropharyngeal Neoplasms/radiotherapy , Radiotherapy/methods , Brachytherapy/adverse effects , Brachytherapy/methods , Brachytherapy/standards , Carcinoma/drug therapy , Chemoradiotherapy , Dose Fractionation, Radiation , Humans , Neoplasm Recurrence, Local/radiotherapy , Organs at Risk , Oropharyngeal Neoplasms/therapy , Postoperative Care , Radiation Injuries/prevention & control , Radiation Injuries/therapy , Radiotherapy/adverse effects , Radiotherapy/standards , Radiotherapy Dosage , Radiotherapy Planning, Computer-Assisted , Radiotherapy, Adjuvant/methods , Radiotherapy, Adjuvant/standards , Radiotherapy, Image-GuidedABSTRACT
Indication, doses, and technique of radiotherapy for salivary glands carcinoma are presented, and the contribution of neutrons and carbon ions. The recommendations for delineation of the target volumes and organs at risk are detailed.
