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Clinical outcomes among patients with head and neck cancer treated by intensity‐modulated radiotherapy with and without adaptive replanning
Author(s) -
Chen Allen M.,
Daly Megan E.,
Cui Jing,
Mathai Mathew,
Benedict Stanley,
Purdy James A.
Publication year - 2014
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.23477
Subject(s) - medicine , radiation therapy , head and neck , head and neck cancer , basal cell , cancer , radiology , surgery
Background The purpose of this study was to determine the effect of adaptive replanning on clinical outcome among patients treated by intensity‐modulated radiotherapy (IMRT) for head and neck cancer. Methods Three hundred seventeen patients underwent IMRT with daily image‐guidance for newly diagnosed squamous cell carcinoma of the head and neck to a median dose of 66 Gy (range, 60–74 Gy). Of these 317 patients, 51 (16%) underwent adaptive radiotherapy with modification of the original IMRT midway during treatment. Results The 2‐year local‐regional control was 88% for patients treated with adaptive replanning compared with 79% for patients treated without ( p = .01). The median time to local‐regional recurrence for the 4 patients treated by adaptive radiotherapy was 7 months (range, 3–15 months) with all failures occurring within the high‐dose planning target volume (PTV). Conclusion Although the use of routine replanning is probably not necessary, our findings do suggest a significant benefit in appropriately selected patients. © 2014 Wiley Periodicals, Inc. Head Neck 36: 1541–1546, 2014