PMID- 17680220
OWN - NLM
STAT- MEDLINE
DCOM- 20071218
LR  - 20220408
IS  - 0179-7158 (Print)
IS  - 0179-7158 (Linking)
VI  - 183
IP  - 8
DP  - 2007 Aug
TI  - Locoregional failure analysis in head-and-neck cancer patients treated with IMRT.
PG  - 417-23; discussion 424-5
AB  - PURPOSE: Analysis of locoregional failure in head-and-neck cancer (HNC) following 
      intensity-modulated radiation therapy (IMRT), with focus on the location of 
      locoregional failures in relation to the chosen planning target volumes (PTVs) 
      and dose distributions. PATIENTS AND METHODS: Between January 2002 and May 2006, 
      280 HNC patients were subjected to IMRT at the authors' institution. Mean 
      follow-up was 23.2 months (3-59.3 months). Definitive IMRT was performed in 75% 
      of all patients. In 71%, simultaneous cisplatin-based chemotherapy was given. 70% 
      of patients presented with T3/4, T1-2 N2c/3 or recurred disease. Locoregional 
      failure patterns were analyzed. RESULTS: 2-year local, nodal, distant, 
      disease-free, and overall survival rates were 80%, 87%, 87%, 73%, and 82%, 
      respectively. 46 local (16%) and 31 nodal (11%) failures have been observed so 
      far. Local tumor persistence was seen in 23/46 cases (50%), and nodal persistence 
      in 12/31 (39%), respectively. One marginal local failure developed in a patient 
      referred for a recurred oral cavity tumor. Three nodal failures developed outside 
      the PTVs at unexpected locations. All other failures have been confirmed "in 
      field". No failure occurred in level Ib or upper level II. Local failure occurred 
      mainly following definitive IMRT for large tumors, nodal failure only in nodally 
      positive patients with nodal high-risk features. CONCLUSION: The dose-volume 
      concept as used here has shown to be adequate, with disease failure developing at 
      the site of the initial gross tumor manifestation inside the boost volume.
FAU - Studer, Gabriela
AU  - Studer G
AD  - Department of Radiation Oncology, University Hospital, Zurich, Switzerland. 
      gabriela.studer@usz.ch
FAU - Luetolf, Urs M
AU  - Luetolf UM
FAU - Glanzmann, Christoph
AU  - Glanzmann C
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - Germany
TA  - Strahlenther Onkol
JT  - Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et 
      al]
JID - 8603469
SB  - IM
CIN - Strahlenther Onkol. 2007 Oct;183(10):581-2. PMID: 17896091
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Female
MH  - Head and Neck Neoplasms/*mortality/*radiotherapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Neoplasm Recurrence, Local/*mortality/*prevention & control
MH  - Prevalence
MH  - Radiotherapy, Conformal/*mortality
MH  - Risk Assessment/*methods
MH  - Risk Factors
MH  - Survival Analysis
MH  - Survival Rate
MH  - Switzerland/epidemiology
MH  - Treatment Failure
EDAT- 2007/08/08 09:00
MHDA- 2007/12/19 09:00
CRDT- 2007/08/08 09:00
PHST- 2006/08/09 00:00 [received]
PHST- 2007/05/18 00:00 [accepted]
PHST- 2007/08/08 09:00 [pubmed]
PHST- 2007/12/19 09:00 [medline]
PHST- 2007/08/08 09:00 [entrez]
AID - 10.1007/s00066-007-1663-8 [doi]
PST - ppublish
SO  - Strahlenther Onkol. 2007 Aug;183(8):417-23; discussion 424-5. doi: 
      10.1007/s00066-007-1663-8.