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Radiotherapy for Head and Neck Cancer: Evaluation of Triggered Adaptive Replanning in Routine Practice
PURPOSE AND OBJECTIVE: A proportion of patients receiving radiotherapy for head and neck squamous cell carcinoma (HNSCC) require ad hoc treatment re-planning. The aim of this retrospective study is to analyze the patients who required ad hoc re-planning and to identify factors, which may predict nee...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7690320/ https://www.ncbi.nlm.nih.gov/pubmed/33282734 http://dx.doi.org/10.3389/fonc.2020.579917 |
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author | Figen, Metin Çolpan Öksüz, Didem Duman, Evrim Prestwich, Robin Dyker, Karen Cardale, Kate Ramasamy, Satiavani Murray, Patrick Şen, Mehmet |
author_facet | Figen, Metin Çolpan Öksüz, Didem Duman, Evrim Prestwich, Robin Dyker, Karen Cardale, Kate Ramasamy, Satiavani Murray, Patrick Şen, Mehmet |
author_sort | Figen, Metin |
collection | PubMed |
description | PURPOSE AND OBJECTIVE: A proportion of patients receiving radiotherapy for head and neck squamous cell carcinoma (HNSCC) require ad hoc treatment re-planning. The aim of this retrospective study is to analyze the patients who required ad hoc re-planning and to identify factors, which may predict need for re-planning. MATERIALS AND METHODS: A single center evaluation of all patients receiving radical or adjuvant (chemo)radiotherapy (CRT) for HNSCC between January and December 2016 was undertaken. Patients who underwent ad hoc re-planning during the treatment were identified in electronic records. Reasons for re-planning were categorized as: weight loss, tumor shrinkage, changes in patient position and immobilization-related factors. Potential trigger factors for adaptive radiotherapy such as patient characteristics, primary tumor site, stage, concomitant chemotherapy, weight loss ratios, radical/adjuvant treatment, and nutritional interventions were investigated. RESULTS: 31/290 (10.6%) HNSCC patients who underwent radical/adjuvant radiotherapy required re-planning. The adaptive radiotherapy (ART) was performed at a mean fraction of 15. The most common documented reasons for re-planning were tumor shrinkage (35.5%) and weight loss (35.5%). Among the patient/tumor/treatment factors, nasopharyngeal primary site (p = 0.013) and use of concurrent chemotherapy with radiotherapy (p = 0.034) were found to be significantly correlated with the need for re-planning. CONCLUSION: Effective on-treatment verification schedules and close follow up of patients especially with NPC primary and/or treated with concurrent chemoradiotherapy are crucial to identify patients requiring ART. We suggest an individualized triggered approach to ART rather than scheduled strategies as it is likely to be more feasible in terms of utilization of workload and resources. |
format | Online Article Text |
id | pubmed-7690320 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-76903202020-12-04 Radiotherapy for Head and Neck Cancer: Evaluation of Triggered Adaptive Replanning in Routine Practice Figen, Metin Çolpan Öksüz, Didem Duman, Evrim Prestwich, Robin Dyker, Karen Cardale, Kate Ramasamy, Satiavani Murray, Patrick Şen, Mehmet Front Oncol Oncology PURPOSE AND OBJECTIVE: A proportion of patients receiving radiotherapy for head and neck squamous cell carcinoma (HNSCC) require ad hoc treatment re-planning. The aim of this retrospective study is to analyze the patients who required ad hoc re-planning and to identify factors, which may predict need for re-planning. MATERIALS AND METHODS: A single center evaluation of all patients receiving radical or adjuvant (chemo)radiotherapy (CRT) for HNSCC between January and December 2016 was undertaken. Patients who underwent ad hoc re-planning during the treatment were identified in electronic records. Reasons for re-planning were categorized as: weight loss, tumor shrinkage, changes in patient position and immobilization-related factors. Potential trigger factors for adaptive radiotherapy such as patient characteristics, primary tumor site, stage, concomitant chemotherapy, weight loss ratios, radical/adjuvant treatment, and nutritional interventions were investigated. RESULTS: 31/290 (10.6%) HNSCC patients who underwent radical/adjuvant radiotherapy required re-planning. The adaptive radiotherapy (ART) was performed at a mean fraction of 15. The most common documented reasons for re-planning were tumor shrinkage (35.5%) and weight loss (35.5%). Among the patient/tumor/treatment factors, nasopharyngeal primary site (p = 0.013) and use of concurrent chemotherapy with radiotherapy (p = 0.034) were found to be significantly correlated with the need for re-planning. CONCLUSION: Effective on-treatment verification schedules and close follow up of patients especially with NPC primary and/or treated with concurrent chemoradiotherapy are crucial to identify patients requiring ART. We suggest an individualized triggered approach to ART rather than scheduled strategies as it is likely to be more feasible in terms of utilization of workload and resources. Frontiers Media S.A. 2020-11-12 /pmc/articles/PMC7690320/ /pubmed/33282734 http://dx.doi.org/10.3389/fonc.2020.579917 Text en Copyright © 2020 Figen, Çolpan Öksüz, Duman, Prestwich, Dyker, Cardale, Ramasamy, Murray and Şen http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Oncology Figen, Metin Çolpan Öksüz, Didem Duman, Evrim Prestwich, Robin Dyker, Karen Cardale, Kate Ramasamy, Satiavani Murray, Patrick Şen, Mehmet Radiotherapy for Head and Neck Cancer: Evaluation of Triggered Adaptive Replanning in Routine Practice |
title | Radiotherapy for Head and Neck Cancer: Evaluation of Triggered Adaptive Replanning in Routine Practice |
title_full | Radiotherapy for Head and Neck Cancer: Evaluation of Triggered Adaptive Replanning in Routine Practice |
title_fullStr | Radiotherapy for Head and Neck Cancer: Evaluation of Triggered Adaptive Replanning in Routine Practice |
title_full_unstemmed | Radiotherapy for Head and Neck Cancer: Evaluation of Triggered Adaptive Replanning in Routine Practice |
title_short | Radiotherapy for Head and Neck Cancer: Evaluation of Triggered Adaptive Replanning in Routine Practice |
title_sort | radiotherapy for head and neck cancer: evaluation of triggered adaptive replanning in routine practice |
topic | Oncology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7690320/ https://www.ncbi.nlm.nih.gov/pubmed/33282734 http://dx.doi.org/10.3389/fonc.2020.579917 |
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