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Local recurrences after curative IMRT for HNSCC: Effect of different GTV to high-dose CTV margins

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  • Ruta Zukauskaite
  • Christian R Hansen
  • Cai Grau
  • Eva Samsøe
  • Jørgen Johansen
  • Jørgen B B Petersen
  • Elo Andersen
  • Carsten Brink
  • Jens Overgaard
  • Jesper G Eriksen
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INTRODUCTION: The aim was to analyze position of CT-verified local recurrences (LR) and local control (LC) among three centers that used different GTV to CTV1 margins.

MATERIALS AND METHODS: In total, 1576 patients completing radical primary IMRT for larynx, pharynx, oral cavity HNSCC in three centers in Denmark between 2006 and 2012 were included. CT-verified LRs were analyzed as possible points of recurrence origin and compared between groups of small (0-2.5 mm), larger (>2.5 mm), and anatomical GTV-CTV1 margins. The recurrence point's position relative to the GTV and 95% prescription dose was evaluated. Overall local control rate was evaluated using Cox uni- and multi-variate analysis.

RESULTS: After a median follow-up of 41 months, 272 patients had local failure. Median GTV-CTV1 margin in Center1, 2 and 3 was 0.0, 3.7 and 9.7 mm, respectively. 51% of local recurrences were inside the GTV. No difference in distribution of LRs in relation to GTV surface (p = 0.4) or the dose to LRs (p = 0.2) was detected between the groups. A difference in LC was found univariate between the centers (p = 0.03), but not in multivariate analysis (p = 0.4).

CONCLUSIONS: No relation was found between the recurrences' distributions as function of the margins used at three centers. In multivariate analysis, local control was not influenced by the centers.

TidsskriftRadiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
Udgave nummer1
Sider (fra-til)48-55
Antal sider8
StatusUdgivet - jan. 2018

ID: 56565750