TY - JOUR
T1 - A Prospective Phase II Study of Automated Non-Coplanar VMAT for Recurrent Head and Neck Cancer
T2 - Initial Report of Feasibility, Safety, and Patient-Reported Outcomes
AU - Woods, Kaley E.
AU - Ma, Ting Martin
AU - Cook, Kiri A.
AU - Morris, Eric D.
AU - Gao, Yu
AU - Sheng, Ke
AU - Kishan, Amar U.
AU - Hegde, John V.
AU - Felix, Carol
AU - Basehart, Vincent
AU - Narahara, Kelsey
AU - Shen, Zhouhuizi
AU - Tenn, Stephen
AU - Steinberg, Michael L.
AU - Chin, Robert K.
AU - Cao, Minsong
N1 - Publisher Copyright:
© 2022 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2022/2/1
Y1 - 2022/2/1
N2 - This study reports the initial results for the first 15 patients on a prospective phase II clinical trial exploring the safety, feasibility, and efficacy of the HyperArc technique for recurrent head and neck cancer treatment. Eligible patients were simulated and planned with both conventional VMAT and HyperArc techniques and the plan with superior dosimetry was selected for treatment. Dosimetry, delivery feasibility and safety, treatment-related toxicity, and patient-reported quality of life (QOL) were all evaluated. HyperArc was chosen over conventional VMAT for all 15 patients and enabled statistically significant increases in dose conformity (R50% reduced by 1.2 ± 2.1, p < 0.05) and mean PTV and GTV doses (by 15.7 ± 4.9 Gy, p < 0.01 and 17.1 ± 6.0 Gy, p < 0.01, respectively). The average HyperArc delivery was 2.8 min longer than conventional VMAT (p < 0.01), and the mean intrafraction motion was ≤ 0.5 ± 0.4 mm and ≤0.3 ± 0.1◦ . With a median follow-up of 12 months, treatment-related toxicity was minimal (only one grade 3 acute toxicity above baseline) and patient-reported QOL metrics were favorable. HyperArc enabled superior dosimetry and significant target dose escalation compared to conventional VMAT planning, and treatment delivery was feasible, safe, and well-tolerated by patients.
AB - This study reports the initial results for the first 15 patients on a prospective phase II clinical trial exploring the safety, feasibility, and efficacy of the HyperArc technique for recurrent head and neck cancer treatment. Eligible patients were simulated and planned with both conventional VMAT and HyperArc techniques and the plan with superior dosimetry was selected for treatment. Dosimetry, delivery feasibility and safety, treatment-related toxicity, and patient-reported quality of life (QOL) were all evaluated. HyperArc was chosen over conventional VMAT for all 15 patients and enabled statistically significant increases in dose conformity (R50% reduced by 1.2 ± 2.1, p < 0.05) and mean PTV and GTV doses (by 15.7 ± 4.9 Gy, p < 0.01 and 17.1 ± 6.0 Gy, p < 0.01, respectively). The average HyperArc delivery was 2.8 min longer than conventional VMAT (p < 0.01), and the mean intrafraction motion was ≤ 0.5 ± 0.4 mm and ≤0.3 ± 0.1◦ . With a median follow-up of 12 months, treatment-related toxicity was minimal (only one grade 3 acute toxicity above baseline) and patient-reported QOL metrics were favorable. HyperArc enabled superior dosimetry and significant target dose escalation compared to conventional VMAT planning, and treatment delivery was feasible, safe, and well-tolerated by patients.
KW - HyperArc
KW - Non-coplanar VMAT
KW - Recurrent head and neck cancer
KW - Reirradiation
KW - SBRT
UR - http://www.scopus.com/inward/record.url?scp=85124496526&partnerID=8YFLogxK
U2 - 10.3390/cancers14040939
DO - 10.3390/cancers14040939
M3 - Article
C2 - 35205686
AN - SCOPUS:85124496526
SN - 2072-6694
VL - 14
JO - Cancers
JF - Cancers
IS - 4
M1 - 939
ER -