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Open Access 01-12-2013 | Research

Late term tolerance in head neck cancer patients irradiated in the IMRT era

Authors: Gabriela Studer, Claudia Linsenmeier, Oliver Riesterer, Yousef Najafi, Michelle Brown, Bita Yousefi, Marius Bredell, Gerhard Huber, Stephan Schmid, Stephan Studer, Roger Zwahlen, Tamara Rordorf, Christoph Glanzmann

Published in: Radiation Oncology | Issue 1/2013

Abstract

Background

The aim was to quantify severe transient and persisting late term effects in our single institution head neck cancer (HNC) cohort treated with curatively intended intensity modulated radiation therapy (IMRT). Hypothesis was if a 2-year follow up (FU) is sufficient to estimate the long term tolerance in HNC irradiated in the IMRT era.

Methods

Between 01/2002-8/2012, 707/1211 (58%) consecutively treated IMRT patients met the inclusion criteria of a FU time >12 months and loco-regional disease control (LRC). 45% presented with loco-regionally advanced disease; 55% were referred for curative definitive IMRT (66 Gy-72 Gy in 30–35 fractions), 45% underwent postoperative IMRT (60-66 Gy in 30–33 fractions). Systemic concomitant therapy was administered in 85%. Highly consistent treatment procedures were performed with respect to contouring processes, dose constraints, radiation schedules, and the use of systemic therapy. Grade 3/4 late term effects were prospectively assessed and analyzed with respect to subgroups at particular risk for specific late effects.

Results

Mean/median FU of the cohort was 41/35 months (15–124). 13% of the patients (92/707) experienced any grade 3/4 late effects (101 events in 92/707 patients), 81% in the first 12 months after radiation. 4% of all developed persisting late grade 3/4 effects (25 events in 25/707 patients).

Conclusions

IMRT led to a high late term tolerance in loco-regionally disease free HNC patients. The onset of any G3/4 effects showed a plateau at 2 years. The question of the cervical vessel tolerance in disease free long time survivors is still open and currently under evaluation at our institution.

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Title: Late term tolerance in head neck cancer patients irradiated in the IMRT era
Authors: Gabriela Studer
Claudia Linsenmeier
Oliver Riesterer
Yousef Najafi
Michelle Brown
Bita Yousefi
Marius Bredell
Gerhard Huber
Stephan Schmid
Stephan Studer
Roger Zwahlen
Tamara Rordorf
Christoph Glanzmann
Publication date: 01-12-2013
Publisher: BioMed Central
Published in: Radiation Oncology / Issue 1/2013
Electronic ISSN: 1748-717X
DOI: https://doi.org/10.1186/1748-717X-8-259

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Late term tolerance in head neck cancer patients irradiated in the IMRT era

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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