naa a22 4500 510763715 CHVBK 20180411083149.0 cr unu---uuuuu 180411e20130301xx s 000 0 eng 10.1007/s12094-012-0911-2 doi (NATIONALLICENCE)springer-10.1007/s12094-012-0911-2 IMRT: preliminary results in a series of advanced head-and-neck cancer patients [Elektronische Daten] [Antonio Vila Capel, Jorge Vilar Palop, Agustín Pedro Olivé, Alberto Sanchez-Reyes Fernandez, Jordi Vayreda Ribera, Joan Julià Sanahuja, Joaquim Pérez de Olaguer Agustín, Nuria Artola Codina, Luis Moya Cascant, Esther Rubio Calatayud, Gemma Carrera Domenech] Purpose: To determine retrospectively 2-3year local and regional control (LRC), free-of-disease survival (FDS) and overall survival (OS), as well as summarized toxicities in a group of 31 advanced head-and-neck cancer patients, treated at our institution between 2004 and 2011 with definitive IMRT low-dose concomitant boost, the majority of them with concurrent chemotherapy based on cisplatin. The results are also shown in the sub-group of nasopharyngeal cancer patients (NPC: 15 cases). Patients and methods: Radiological basal and contrasted CT series, MR-CT or PET/CT fused images in the setup position with immobilization mask were registered in simulation therapy patients. Planed doses were: 70Gy in primary tumor and positive nodes >1cm; 63Gy in high-risk areas of microscopic diseases +10mm safety margin; and 56Gy in low risk of diseases regional lymph nodes. Treatment was delivered using a Varian 2100 Clinac with sliding windows IMRT. Spinal cord doses were limited to a strict maximum of 45Gy, and optimization aimed for mean doses in parotid glands below 26Gy, especially in the contralateral parotid gland. Online DRR-portal X-ray comparison images were taken every day with a deviation module tolerance ≤3mm. Results: The mean follow-up since IMRT was 34months (interval: 8-89; median 31months). Median follow-up in living patients was 22months. The 2-year rate for global LRC was 64%, for FDS 61% and OS 77%. For the NPC group after 2years, LRC was 73%, FDS 73% and OS 93%. The 3-year rates were similar. Seven patients died as a consequence of local and/or regional progression (mean time 10months). Relapses were observed in eight patients (26%), but only seven could be confirmed by biopsy (22.6%; mean time to relapse: 8.6months). Global acute mucositis was 61% and chronic mucositis was shown in six cases which developed xerostomia (19%) in the first control after IMRT, but 1year later it was reduced to only four patients, two Grade 2 and two Grade 1. Conclusions: No excessive, unwarranted toxicities were observed using concomitant low doses boost in IMRT. High rates of compliance to concurrent chemotherapy were achieved. Late xerostomia associated with this regime decreased 1year after conclusion of treatment. The implementation of IMRT requires advances in imaging for better tumor delineation; otherwise the physician loses the advantage of dose modulation or faces a risk of geographical miss. Federación de Sociedades Españolas de Oncología (FESEO), 2012 IMRT nationallicence Advanced head-and-neck cancer nationallicence Preliminary results nationallicence Toxicity nationallicence Vila Capel Antonio Unitat de Radioteràpia i Oncologia, Hospital Plató, C/Plató21, 08006, Barcelona, Spain aut Vilar Palop Jorge Unitat de Radioteràpia i Oncologia, Hospital Plató, C/Plató21, 08006, Barcelona, Spain aut Pedro Olivé Agustín Unitat de Radioteràpia i Oncologia, Hospital Plató, C/Plató21, 08006, Barcelona, Spain aut Sanchez-Reyes Fernandez Alberto Instituto Madrileño de Oncologia IMO, Madrid, Spain aut Vayreda Ribera Jordi Institut Català D'Oncologia, Hospital Josep Trueta, Girona, Spain aut Julià Sanahuja Joan Unitat de Radioteràpia i Oncologia, Hospital Plató, C/Plató21, 08006, Barcelona, Spain aut Pérez de Olaguer Agustín Joaquim Unitat de Radioteràpia i Oncologia, Hospital Plató, C/Plató21, 08006, Barcelona, Spain aut Artola Codina Nuria Unitat de Radioteràpia i Oncologia, Hospital Plató, C/Plató21, 08006, Barcelona, Spain aut Moya Cascant Luis Unitat de Radioteràpia i Oncologia, Hospital Plató, C/Plató21, 08006, Barcelona, Spain aut Rubio Calatayud Esther Unitat de Radioteràpia i Oncologia, Hospital Plató, C/Plató21, 08006, Barcelona, Spain aut Carrera Domenech Gemma Unitat de Radioteràpia i Oncologia, Hospital Plató, C/Plató21, 08006, Barcelona, Spain aut Clinical and Translational Oncology Springer Milan 15/3(2013-03-01), 233-242 1699-048X 15:3<233 2013 15 12094 https://doi.org/10.1007/s12094-012-0911-2 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12094-012-0911-2 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Vila Capel Antonio Unitat de Radioteràpia i Oncologia, Hospital Plató, C/Plató21, 08006, Barcelona, Spain aut NATIONALLICENCE 700 1- Vilar Palop Jorge Unitat de Radioteràpia i Oncologia, Hospital Plató, C/Plató21, 08006, Barcelona, Spain aut NATIONALLICENCE 700 1- Pedro Olivé Agustín Unitat de Radioteràpia i Oncologia, Hospital Plató, C/Plató21, 08006, Barcelona, Spain aut NATIONALLICENCE 700 1- Sanchez-Reyes Fernandez Alberto Instituto Madrileño de Oncologia IMO, Madrid, Spain aut NATIONALLICENCE 700 1- Vayreda Ribera Jordi Institut Català D'Oncologia, Hospital Josep Trueta, Girona, Spain aut NATIONALLICENCE 700 1- Julià Sanahuja Joan Unitat de Radioteràpia i Oncologia, Hospital Plató, C/Plató21, 08006, Barcelona, Spain aut NATIONALLICENCE 700 1- Pérez de Olaguer Agustín Joaquim Unitat de Radioteràpia i Oncologia, Hospital Plató, C/Plató21, 08006, Barcelona, Spain aut NATIONALLICENCE 700 1- Artola Codina Nuria Unitat de Radioteràpia i Oncologia, Hospital Plató, C/Plató21, 08006, Barcelona, Spain aut NATIONALLICENCE 700 1- Moya Cascant Luis Unitat de Radioteràpia i Oncologia, Hospital Plató, C/Plató21, 08006, Barcelona, Spain aut NATIONALLICENCE 700 1- Rubio Calatayud Esther Unitat de Radioteràpia i Oncologia, Hospital Plató, C/Plató21, 08006, Barcelona, Spain aut NATIONALLICENCE 700 1- Carrera Domenech Gemma Unitat de Radioteràpia i Oncologia, Hospital Plató, C/Plató21, 08006, Barcelona, Spain aut NATIONALLICENCE 773 0- Clinical and Translational Oncology Springer Milan 15/3(2013-03-01), 233-242 1699-048X 15:3<233 2013 15 12094 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer