Title Reduction of target volume post induction chemotherapy using PET/CT in locally advanced HNSCC /
Authors Rudžianskas, Viktoras ; Korobeinikova, Erika ; Inčiūra, Arturas ; Rudžianskienė, Milda ; Jaselskė, Evelina ; Adlienė, Diana
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Is Part of Radiotherapy and oncology : ESTRO 37, 20-24 April 2018, Barcelona, Spain.. Amsterdam : Elsevier. 2018, vol. 127, suppl. 1, EP-1111, p. 628.. ISSN 0167-8140
Keywords [eng] chemotherapy ; PET/CT ; HNSCC
Abstract [eng] Purpose or Objective. Superiority of post-IC (induction chemotherapy) GTV (gross tumour volume) over pre-IC GTV still has not been tested. We assessed the results of patients with locoregionally advanced head and neck squamous cell cancer (LAHNSCC) treatment with IC following by chemoradiotherapy (CRT), using post-IC PET/CT images for IMRT planning. Material and Methods. Two PET/CT were performed: one prior IC, and one 14 days after 3 cycles of IC (docetaxel 75mg/m2, cisplatin 75mg/m2 and 5-FU 750 mg/m2 day 1-5). The gross tumour volume (GTV70) and gross nodal disease (GTV60) on the post-IC PET/CT scans were contoured by the radiation oncologist working in cooperation with an experienced nuclear medicine physician.. The boost clinical target volume (CTV70) and nodal clinical target volume (CTV60) were obtained by GTV70 and GTV60 plus 5 mm respectively. The elective CTV (CTV50) included CTV70, CTV60 and bilateral elective lymphnodes. The margin of 3 mm was added for each CTV to create the planning target volumes (PTV70, PTV60 and PTV50). For high-risk volumes (PTV70 and PTV60) the prescribed doses were 70 Gy and 60 Gy respectively, for PTV50 – 50 Gy. CRT consisted of a chemotherapy with cisplatin (40 mg/m2 weekly) and RT (2 Gy once daily, 5 days a week). The primary end points was PFS. Secondary end points were OS and treatment toxicities. Acute toxicities were assessed using CTCAE v.4.0, late toxicities - using RTOG /EORTC criteria. Results 47 patients with histologically confirmed LAHNSCC (oroand hypopharyngeal), HPV negative, KPS 70% and signed written informed consent approved by the Lithuanian Bioethics Committee. The mean follow-up period was 30.1 (7-55) months. The mean PFS was 38.8 months (95% CI, 33.1-44.6) and mean OS was 38.1 months (95% CI, 32.7-43.4). The 3-years PFS and OS rate were 59% and 52%, respectively. The most common acute toxicities of grade 3-4 were febrile neutropenia 13.4%, leucopenia 23%, mucositis 30.2%. Late toxicities of grade 3-4 were: dysphagia 4.2%, xerostomia 6.4% and osteoradionecrosis 2.1%. Conclusion. This study suggests the efficacy of post-IC PET/CT based target volume delineation in selected patients undergoing IMRT for LAHNSCC. Further analysis is required to ascertain main clinical outcomes.
Published Amsterdam : Elsevier
Type Conference paper
Language English
Publication date 2018