TY - JOUR
T1 - Local recurrences after curative IMRT for HNSCC
T2 - Effect of different GTV to high-dose CTV margins
AU - Zukauskaite, Ruta
AU - Hansen, Christian R
AU - Grau, Cai
AU - Samsøe, Eva
AU - Johansen, Jørgen
AU - Petersen, Jørgen B B
AU - Andersen, Elo
AU - Brink, Carsten
AU - Overgaard, Jens
AU - Eriksen, Jesper G
N1 - Copyright © 2017 Elsevier B.V. All rights reserved.
PY - 2018/1
Y1 - 2018/1
N2 - 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.
AB - 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.
KW - Carcinoma, Squamous Cell/pathology
KW - Dose-Response Relationship, Radiation
KW - Female
KW - Head and Neck Neoplasms/pathology
KW - Humans
KW - Male
KW - Neoplasm Recurrence, Local/pathology
KW - Neoplasm Staging
KW - Radiotherapy Dosage
KW - Radiotherapy Planning, Computer-Assisted/methods
KW - Radiotherapy, Intensity-Modulated/methods
KW - Squamous Cell Carcinoma of Head and Neck
U2 - 10.1016/j.radonc.2017.11.024
DO - 10.1016/j.radonc.2017.11.024
M3 - Journal article
C2 - 29248171
SN - 0167-8140
VL - 126
SP - 48
EP - 55
JO - Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
JF - Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
IS - 1
ER -