Estimation of Radiotherapy Efficiency of Head-and-Neck Cancer Based

2021 ◽  
Vol 66 (5) ◽  
pp. 95-100
Author(s):  
E. Sukhikh ◽  
L. Sukhikh ◽  
Ya. Sutygina ◽  
P. Izhevsky ◽  
I. Sheino ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Neck Cancer ◽  
Treatment Time ◽  
Tumor Control ◽  
Head Neck Cancer ◽  
Tumor Control Probability ◽  
Total Treatment Time ◽  
Total Treatment ◽  
Treatment Plans ◽  
Head Neck

Purpose: Evaluation of the expected effectiveness of radiation therapy based on models of the local tumor control probability (Tumor Control Probability – TCP) for the head-neck cancer. Material and methods: The study used data from 11 patients with locally advanced head-neck cancer (larynx, oropharynx, and oral cavity). For each patient two dosimetric treatment plans have been prepared: SIB-VMAT (70 Gy per tumor, 50 Gy per lymph nodes, 25 fractions) and SEQ-VMAT (70 Gy per tumor, 50 Gy per lymph nodes, 35 fractions). The developed plans were analyzed using A. Niemierko's TCP model with parameters obtained by B. Maciejewski (TCD50 = 70.26 Gy with a 49-day total treatment time), taking into account the dose–volume histograms and the total treatment time. Results: The developed plans ensured a high level of coverage (98–98 %) of the Clinical treatment volume (CTV) in all but one patient. The average TCP SIB-VMAT is 99.9 % due to the very short total treatment time. The average TCP for SEQ-VMAT is 61.0%. For one patient, both SIB-VMAT and SEQ-VMAT showed zero expected efficacy due to 95–95 % CTV coverage. Conclusion: The use of TCP model allows analyzing personalized treatment plans for patients and developing adaptive treatment regimens with an increase in the total dose, dose per fraction, and a decrease in the total treatment time.

Simultaneous radiochemotherapy versus radiotherapy alone in advanced head and neck cancer: a randomized multicenter study.

1998 ◽  
Vol 16 (4) ◽  
pp. 1318-1324 ◽  
Author(s):  
T G Wendt ◽  
G G Grabenbauer ◽  
C M Rödel ◽  
H J Thiel ◽  
H Aydin ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Continuous Infusion ◽  
Neck Cancer ◽  
Treatment Time ◽  
Hematologic Toxicity ◽  
Advanced Head ◽  
Failure Patterns ◽  
Total Treatment Time ◽  
Total Treatment

PURPOSE A prospective randomized multicenter trial was performed to evaluate the contribution of simultaneously administered chemotherapy (CT) and radiotherapy (RT) in previously untreated patients with unresectable stage III/IV head and neck cancer. PATIENTS AND METHODS Patients with locoregionally advanced head and neck cancer were treated either with RT alone (arm A) or simultaneous RT plus CT (RCT; arm B). RT was identical in both arms and administered in three courses with 13 fractions of 1.8 Gy each twice daily. During one course, from day 3 to 11, 23.4 Gy was delivered. In arm B, cisplatin (CDDP) 60 mg/m2, fluorouracil (5-FU) 350 mg/m2 by intravenous (i.v.) bolus, and leucovorin (LV) 50 mg/m2 by i.v. bolus were given on day 2, and 5-FU 350 mg/m2/24 hour by continuous infusion and LV 100 mg/m2/24 hours by continuous infusion were given from day 2 to 5. Treatment was repeated on days 22 and 44; a total RT dose of 70.2 Gy was administered. Treatment breaks were scheduled from days 12 to 21 and days 34 to 43. RESULTS From 1989 to 1993, 298 patients were enrolled and 270 patients were assessable. Acute mucositis grade 3 or 4 was more frequent in arm B (38%) than in arm A (16%) (P < .001). Total treatment time was significantly longer in arm B than in arm A (P < .001) due to prolonged breaks. According to hematologic toxicity, scheduled drug doses were given in 74% of patients for the second course and 46% for the third course. The 3-year overall survival rate was 24% in arm A and 48% in arm B (P < .0003). The 3-year locoregional control rate was 17% in arm A and 36% in arm B (P < .004). Both arms showed similar distant failure patterns (arm A, 13 of 140; arm B, 12 of 130). Serious late side effects were not significantly different between treatment arms (arm A, 6.4%; arm B, 10%; not significant). CONCLUSION Concomitant CT offered improved disease control and survival in advanced head and neck cancer patients. Due to increased acute toxicity, more supportive care is demanded when CT is given simultaneously. Increased total treatment time does not exert a negative impact on outcome in this combined modality regimen.

Chemotherapy followed by accelerated fractionated radiation for larynx preservation in patients with advanced laryngeal cancer.

1996 ◽  
Vol 14 (8) ◽  
pp. 2322-2330 ◽  
Author(s):  
A Eisbruch ◽  
A F Thornton ◽  
S Urba ◽  
R M Esclamado ◽  
W R Carroll ◽  
...  
Keyword(s):  
Laryngeal Cancer ◽  
Treatment Time ◽  
Complete Response ◽  
Definitive Treatment ◽  
Tumor Control ◽  
Total Study Population ◽  
Larynx Preservation ◽  
Locoregional Failure ◽  
Total Treatment Time ◽  
Total Treatment

PURPOSE Larynx preservation in advanced, resectable laryngeal cancer may be achieved using induction chemotherapy (CT) followed in responding patients by definitive radiation (RT). To address potential accelerated repopulation of clonogenic tumor cells during the prolonged total treatment time, we studied the feasibility of accelerated fractionated RT after CT. METHODS Patients with advanced laryngeal cancer received two cycles of cisplatin 100 mg/m2 and fluorouracil (5-Fu) 1,000 mg/m2/d for 5 days. Responding patients received a third cycle after which those who had complete response or tumor down-staging to T1 proceeded with accelerated RT: 70.4 Gy delivered over 5.5 weeks. Patients who achieved a lesser response to CT underwent total laryngectomy and postoperative RT. RESULTS Thirty-three patients were accrued. Three died during the course of CT and two declined definitive treatment after CT. Twenty-one patients had a major response to CT, 20 of whom received accelerated RT. Median weight loss during RT was 11%. Late severe morbidity was observed in five patients (25%). All four patients who underwent salvage laryngectomy after accelerated RT experienced major postoperative complications. The locoregional failure rate was 25%. The larynx was preserved in 48% of the total study population and in 80% of the patients irradiated according to the study protocol. CONCLUSION Accelerated RT after CT as delivered in this study may increase both acute and long-term morbidity rates compared with studies using standard RT after CT. It did not seem to improve local/regional tumor control or survival despite stringent patient selection criteria.

564Does total treatment time of the mediastinal lymph nodes affect survival time for esophageal cancer?

1996 ◽  
Vol 40 ◽  
pp. S144
Author(s):  
M. Schmuecking ◽  
G. Kovács ◽  
U. Schmidt ◽  
P. Kohr ◽  
W. Strate ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Lymph Nodes ◽  
Survival Time ◽  
Treatment Time ◽  
Mediastinal Lymph Nodes ◽  
Total Treatment Time ◽  
Total Treatment

Vital Tooth Whitening Techniques. A literature Review

2020 ◽  
Vol 02 ◽  
Author(s):  
Pia Chatterjee Kirk
Keyword(s):  
Soft Tissues ◽  
Treatment Time ◽  
Tooth Bleaching ◽  
Tooth Whitening ◽  
Easy Method ◽  
Tooth Structure ◽  
Dental Esthetics ◽  
Total Treatment Time ◽  
Restorative Materials ◽  
Total Treatment

Background: Vital tooth whitening has become an integral part of esthetic dentistry and remains one of the safest and most economic options today to improve dental esthetics without removing tooth structure. The tooth whitening materials have evolved into three categories: dentist-prescribed/dispensed (in office and patient home-use), and over-thecounter purchased and applied by patients. Objective: This review outlines the latest advances in dentist prescribed vital teeth whitening techniques, effects on tooth structure, soft tissues, and dental restoratives. Areas requiring additional research are also discussed. Methods: Electronic and manual literature search was conducted for key words such as tooth bleaching, and dental bleaching techniques using PubMed/MEDLINE, followed by manual selection of the studies that included whitening procedures in vital teeth. Results: The two main whitening agents are carbamide peroxide (CP) and hydrogen peroxide (HP or H2O2) whose concentration, duration of contact, and total treatment time can alter results. In addition, factors including the type of stain, and age of patient can affect results. Although whitening agents can affect tooth structure, restorative materials, and gingival tissues, the changes are temporary or can be treated using minimally invasive techniques. Conclusion: Areas requiring further research include the actual mechanism of whitening, its effect on tooth structure and restorative materials, and the development of an easy method to quantitate the degree of whitening in the dental office.

Is Locally Advanced Head-Neck Cancer One More Candidate for Accelerated Hypofractionation?

2021 ◽  
Vol 41 (1) ◽  
pp. 467-475
Author(s):  
IOANNIS M. KOUKOURAKIS ◽  
ANNA ZYGOGIANNI ◽  
VASSILIOS KOULOULIAS ◽  
GEORGE KYRGIAS ◽  
MARIANTHI PANTELIADOU ◽  
...  
Keyword(s):  
Neck Cancer ◽  
Locally Advanced ◽  
Head Neck Cancer ◽  
Advanced Head ◽  
Head Neck

scholarly journals Automated Non-Coplanar VMAT for Dose Escalation in Recurrent Head and Neck Cancer Patients

Cancers ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 1910
Author(s):  
Kaley Woods ◽  
Robert K. Chin ◽  
Kiri A. Cook ◽  
Ke Sheng ◽  
Amar U. Kishan ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Dose Escalation ◽  
Volumetric Modulated Arc Therapy ◽  
Normal Tissue Complication Probability ◽  
Tumor Control ◽  
Tumor Control Probability ◽  
Increased Risk ◽  
Recurrent Head

This study evaluates the potential for tumor dose escalation in recurrent head and neck cancer (rHNC) patients with automated non-coplanar volumetric modulated arc therapy (VMAT) stereotactic body radiation therapy (SBRT) planning (HyperArc). Twenty rHNC patients are planned with conventional VMAT SBRT to 40 Gy while minimizing organ-at-risk (OAR) doses. They are then re-planned with the HyperArc technique to match these minimal OAR doses while escalating the target dose as high as possible. Then, we compare the dosimetry, tumor control probability (TCP), and normal tissue complication probability (NTCP) for the two plan types. Our results show that the HyperArc technique significantly increases the mean planning target volume (PTV) and gross tumor volume (GTV) doses by 10.8 ± 4.4 Gy (25%) and 11.5 ± 5.1 Gy (26%) on average, respectively. There are no clinically significant differences in OAR doses, with maximum dose differences of <2 Gy on average. The average TCP is 23% (± 21%) higher for HyperArc than conventional plans, with no significant differences in NTCP for the brainstem, cord, mandible, or larynx. HyperArc can achieve significant tumor dose escalation while maintaining minimal OAR doses in the head and neck—potentially enabling improved local control for rHNC SBRT patients without increased risk of treatment-related toxicities.

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