Predictive factors of local-regional recurrences following parotid sparing intensity modulated or 3D conformal radiotherapy for head and neck cancer

Mary Feng, Siavash Jabbari, Alexander Lin, Carol R. Bradford, Douglas B. Chepeha, Theodoros N. Teknos, Francis P. Worden, Christina Tsien, Matthew J. Schipper, Gregory T. Wolf, Laura A. Dawson, Avraham Eisbruch

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25 Scopus citations

Abstract

Background and purpose: Predictive factors for local-regional (LR) failures after parotid-sparing, Intensity modulated (IMRT) or 3D conformal radiotherapy for head and neck (HN) cancers were assessed. Patients and methods: One hundred and fifty-eight patients with mostly stages III-IV HN squamous cell carcinoma underwent curative bilateral neck irradiation aimed at sparing the parotid glands. Patient, tumor, and treatment factors were analyzed as predictive factors for LR failure. Results: Twenty-three patients had LR recurrence (19 in-field and four marginal). No differences were found in the doses delivered to the PTVs of patients with or without in-field recurrences. In univariate analysis, tumor site was highly predictive for LR failure in both postoperative and definitive RT patients. In postoperative RT patients, pathologic tumor size, margin status, extracapsular extension (ECE) and number of lymph node metastases, were also significantly predictive. Multivariate analysis showed tumor site (oropharynx vs. other sites) to be a significant predictor in all patients, and involved margins and number of involved lymph nodes in postoperative patients. Conclusions: Clinical rather than dosimetric factors predicted for LR failures in this series, and were similar to those reported following standard RT. These factors may aid in the selection of patients for studies of treatment intensification using IMRT.

Original languageEnglish
Pages (from-to)32-38
Number of pages7
JournalRadiotherapy and Oncology
Volume77
Issue number1
DOIs
StatePublished - Oct 1 2005

Keywords

  • Head and neck cancer
  • IMRT
  • Predictive factors

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    Feng, M., Jabbari, S., Lin, A., Bradford, C. R., Chepeha, D. B., Teknos, T. N., Worden, F. P., Tsien, C., Schipper, M. J., Wolf, G. T., Dawson, L. A., & Eisbruch, A. (2005). Predictive factors of local-regional recurrences following parotid sparing intensity modulated or 3D conformal radiotherapy for head and neck cancer. Radiotherapy and Oncology, 77(1), 32-38. https://doi.org/10.1016/j.radonc.2005.07.008