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Title: Marginal Misses After Postoperative Intensity-Modulated Radiotherapy for Head and Neck Cancer

Abstract

Purpose: To describe the spatial distribution of local-regional recurrence (LRR) among patients treated postoperatively with intensity-modulated radiotherapy (IMRT) for head and neck cancer. Methods and Materials: The medical records of 90 consecutive patients treated by gross total resection and postoperative IMRT for squamous cell carcinoma of the head and neck from January 2003 to July 2009 were reviewed. Sites of disease were the oral cavity (43 patients), oropharynx (20 patients), larynx (15 patients), and hypopharynx (12 patients). Fifty patients (56%) received concurrent chemotherapy. Results: Seventeen of 90 patients treated with postoperative IMRT experienced LRR, yielding a 2-year estimate of local regional control of 80%. Among the LRR patients, 11 patients were classified as in-field recurrences, occurring within the physician-designated clinical target volume, and 6 patients were categorized as marginal recurrences. There were no out-of-field geographical misses. Sites of marginal LRRs included the contralateral neck adjacent to the spared parotid gland (3 patients), the dermal/subcutaneous surface (2 patients), and the retropharyngeal/retrostyloid lymph node region (1 patient). Conclusions: Although the incidence of geographical misses was relatively low, the possibility of this phenomenon should be considered in the design of target volumes among patients treated by postoperative IMRT for head and neck cancer.

Authors:
 [1];  [1];  [2]; ; ;  [1]
  1. Department of Radiation Oncology, University of California Davis School of Medicine, Sacramento, California (United States)
  2. Department of Otolaryngology-Head and Neck Surgery, University of California Davis School of Medicine, Sacramento, California (United States)
Publication Date:
OSTI Identifier:
21587645
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 80; Journal Issue: 5; Other Information: DOI: 10.1016/j.ijrobp.2010.04.011; PII: S0360-3016(10)00529-8; Copyright (c) 2011 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CARCINOMAS; CHEMOTHERAPY; GLANDS; HEAD; LARYNX; LYMPH NODES; MEDICAL RECORDS; NECK; ORAL CAVITY; RADIOTHERAPY; BODY; DIGESTIVE SYSTEM; DISEASES; LYMPHATIC SYSTEM; MEDICINE; NEOPLASMS; NUCLEAR MEDICINE; ORGANS; RADIOLOGY; RESPIRATORY SYSTEM; THERAPY

Citation Formats

Chen, Allen M., E-mail: allen.chen@ucdmc.ucdavis.edu, Farwell, D. Gregory, Luu, Quang, Chen, Leon M., Vijayakumar, Srinivasan, and Purdy, James A. Marginal Misses After Postoperative Intensity-Modulated Radiotherapy for Head and Neck Cancer. United States: N. p., 2011. Web. doi:10.1016/j.ijrobp.2010.04.011.
Chen, Allen M., E-mail: allen.chen@ucdmc.ucdavis.edu, Farwell, D. Gregory, Luu, Quang, Chen, Leon M., Vijayakumar, Srinivasan, & Purdy, James A. Marginal Misses After Postoperative Intensity-Modulated Radiotherapy for Head and Neck Cancer. United States. doi:10.1016/j.ijrobp.2010.04.011.
Chen, Allen M., E-mail: allen.chen@ucdmc.ucdavis.edu, Farwell, D. Gregory, Luu, Quang, Chen, Leon M., Vijayakumar, Srinivasan, and Purdy, James A. Mon . "Marginal Misses After Postoperative Intensity-Modulated Radiotherapy for Head and Neck Cancer". United States. doi:10.1016/j.ijrobp.2010.04.011.
@article{osti_21587645,
title = {Marginal Misses After Postoperative Intensity-Modulated Radiotherapy for Head and Neck Cancer},
author = {Chen, Allen M., E-mail: allen.chen@ucdmc.ucdavis.edu and Farwell, D. Gregory and Luu, Quang and Chen, Leon M. and Vijayakumar, Srinivasan and Purdy, James A.},
abstractNote = {Purpose: To describe the spatial distribution of local-regional recurrence (LRR) among patients treated postoperatively with intensity-modulated radiotherapy (IMRT) for head and neck cancer. Methods and Materials: The medical records of 90 consecutive patients treated by gross total resection and postoperative IMRT for squamous cell carcinoma of the head and neck from January 2003 to July 2009 were reviewed. Sites of disease were the oral cavity (43 patients), oropharynx (20 patients), larynx (15 patients), and hypopharynx (12 patients). Fifty patients (56%) received concurrent chemotherapy. Results: Seventeen of 90 patients treated with postoperative IMRT experienced LRR, yielding a 2-year estimate of local regional control of 80%. Among the LRR patients, 11 patients were classified as in-field recurrences, occurring within the physician-designated clinical target volume, and 6 patients were categorized as marginal recurrences. There were no out-of-field geographical misses. Sites of marginal LRRs included the contralateral neck adjacent to the spared parotid gland (3 patients), the dermal/subcutaneous surface (2 patients), and the retropharyngeal/retrostyloid lymph node region (1 patient). Conclusions: Although the incidence of geographical misses was relatively low, the possibility of this phenomenon should be considered in the design of target volumes among patients treated by postoperative IMRT for head and neck cancer.},
doi = {10.1016/j.ijrobp.2010.04.011},
journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 5,
volume = 80,
place = {United States},
year = {2011},
month = {8}
}