Kazuhisa Furutani MD, PhD, Presenter: Nothing to Disclose

Hidetoshi Shimizu RT, BSC, Abstract Co-Author: Nothing to Disclose

Yoko Goto MD, Abstract Co-Author: Nothing to Disclose

Natsuo Tomita MD, Abstract Co-Author: Nothing to Disclose

Hiroyuki Tachibana MD, Abstract Co-Author: Nothing to Disclose

Takeshi Kodaira MD, Abstract Co-Author: Nothing to Disclose

Nobutaka Mizoguchi MD, Abstract Co-Author: Nothing to Disclose

Rie Nakahara MD, Abstract Co-Author: Nothing to Disclose

Motoo Nomura MD, Abstract Co-Author: Nothing to Disclose

Purpose/Objective(s): To determine the outcomes and the failure patterns of head and neck squamous cell carcinoma (HNSCC) after definitive intensity-modulated radiotherapy (IMRT) by helical tomotherapy."Material/Methods: Helical tomotherapy was installed in Aichi Cancer Center at June 2006, and 71 patients with HNSCC were treated with IMRT for curative intent in initial two years. We reviewed the charts of the 71 consecutive patients. Tumor sites were nasopharynx (58%), oropharynx (22%), hypopharynx (10%), sinonasal cavity (6%), oral cavity (3%), and external auditory canal (1%). Of the 71 patients, 67 (94%) received platinum-based chemotherapy. Two target volumes were defined (PTV1 as a high-risk target volume and PTV2 as a low-risk target volume). The prescribed dose was 60 to 70Gy (median, 70Gy) to PTV1 and 54Gy to PTV2. All patients were treated with a concomitant boost schedule. The failure patterns were determined by comparison of the computed tomography images at the time of planning and images obtained at the time of recurrence. Central failures or marginal failures were defined as those that arose in a PTV1 or at a high dose gradient region of target volume, respectively.""Results: The median follow-up of all patients was 25.0 months (range, 2.9-44.3 months). Nineteen patients had locoregional failures (13 local failures only, 3 regional failures only, and 3 local and reginal failures). Of the 16 local failures, 13 were central failures and 3 were marginal failures. Of the 6 regional failures, 4 were central failures and 2 were marginal failures. Seven patients failed distantly (all patients had also locoreginal failures). The 2-year local control rate, locoregional control rate, relapse free survival rate, and overall survival rate for these patients was 78%, 73%, 68%, and 85%, respectively. Grade ?3 late complications were observed in six patients (8%).""Conclusion: Helical tomotherapy was effective for HNSCC. Major failure pattern was central failure, but some cases of marginal failure suggest potential hazard of inadequate target volume contouring at treatment planning. Careful and accurate contouring of target volumes is essential in IMRT planning."

Furutani, K, Shimizu, H, Goto, Y, Tomita, N, Tachibana, H, Kodaira, T, Mizoguchi, N, Nakahara, R, Nomura, M, Helical Tomotherapy for the Treatment of Head and Neck Cancer: Clinical Outcomes and Failure Patterns.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9020107.html