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Long-term clinical experience with helical tomotherapy for head and neck cancer

  • Original Research
  • Published:
Journal of Radiation Oncology

Abstract

Objective

The objective of this study is to review a long-term single-institutional experience with helical tomotherapy (HT) for the radiotherapeutic management of head and neck cancer.

Methods

From February 2006 to January 2013, a total of 301 consecutive patients with squamous cell carcinoma of the head and neck were treated with HT to a median dose of 66 Gy (range, 60 to 72 Gy). One hundred and seventy patients (56 %) underwent definitive HT and 131 patients (44 %) were treated post-operatively after surgery. There was no significant imbalance in patient or disease characteristics among patients treated with or without surgery (p > 0.05). Megavoltage computed tomography (MVCT) scans were obtained for patient alignment prior to each delivered fraction. Concurrent chemotherapy was administered to 133 patients (43 %).

Results

The 3-year estimates of overall survival, local-regional control, and disease-free survival were 76, 82, and 69 %, respectively. No difference existed with any of these endpoints among patients treated by definitive surgery versus radiation (p > 0.05). The incidence of grade 3+ acute toxicity was 30 %, with the most common related to skin erythema/desquamation, oral mucositis, esophagitis, dysguesia, and xerostomia. Post-HT esophageal stricture requiring dilatation was diagnosed in 12 %. Thirty (10 %) and 16 patients (5 %) were gastrostomy tube-dependent at 6 months and 1 year after HT, respectively.

Conclusion

HT achieves clinical outcomes consistent with other IMRT methods and is an effective means of treatment for head neck cancer either as primary or post-operative therapy.

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Conflict of interest

None of the authors (Allen Chen, Megan Daly, Jing Cui, Julian Perks, James Purdy, Stanley Benedict) have any disclosures or potential conflicts of interest.

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Authors and Affiliations

  1. Department of Radiation Oncology, University of California Davis, Comprehensive Cancer Center, Sacramento, CA, USA

    Allen M. Chen, Megan E. Daly, Jing Cui, Julian Perks, James A. Purdy & Stanley Benedict

  2. Department of Radiation Oncology, David Geffen School of Medicine, University of California, Los Angeles, 200 Medical Plaza B265, Los Angeles, CA, 90095, USA

    Allen M. Chen

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  1. Allen M. Chen
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  2. Megan E. Daly
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  3. Jing Cui
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  4. Julian Perks
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  5. James A. Purdy
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  6. Stanley Benedict
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Correspondence to Allen M. Chen.

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Chen, A.M., Daly, M.E., Cui, J. et al. Long-term clinical experience with helical tomotherapy for head and neck cancer. J Radiat Oncol 3, 355–361 (2014). https://doi.org/10.1007/s13566-014-0157-4

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  • DOI: https://doi.org/10.1007/s13566-014-0157-4

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