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Clinical outcomes for larynx patients with cancer treated with refinement of high‐dose radiation treatment volumes
Author(s) -
Burr Adam R.,
Harari Paul M.,
Haasl Alyx M.,
Wieland Aaron M.,
Bruce Justine Y.,
Kimple Randall J.,
Hartig Gregory K.,
McCulloch Timothy M.,
Witek Matthew E.
Publication year - 2020
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.26098
Subject(s) - medicine , larynx , radiation therapy , dysphagia , nuclear medicine , head and neck cancer , oncology , cancer , carcinoma , surgery
Background To evaluate disease control, toxicities, and dose to dysphagia/aspiration risk structures (DARS) using a direct gross tumor volume (GTV 70Gy ) to planning target volume expansion (dPTV 70Gy ) for patients with squamous cell carcinoma of the larynx (LSCC). Methods A retrospective review was performed on patients with LSCC treated between 2003 and 2018. Clinical outcomes, toxicities, and dosimetric data were analyzed. Results Seventy‐three patients were identified. Overall survival at 5‐years was 57.8%. Five‐year local and regional control was 79.8% and 88.2%, respectively. Distant metastatic‐only failure was 2.7%. Eighty percent of failures were 95% contained within the dPTV 70Gy . Mean dose and the volume of DARS receiving 70 Gy was significantly lower for dPTV 70Gy compared to a consensus‐defined PTV 70Gy . Discussion Judicious reduction in high‐dose target volumes can preserve high tumor control rates while reducing dose to normal surrounding structures underscoring the potential benefit of this approach in enabling local therapy intensification to improve locoregional control.