title: Outcomes of postoperative simultaneous modulated accelerated radiotherapy for head-and-neck squamous cell carcinoma.
abstract: OBJECTIVE
  To evaluate the treatment efficacy and toxicity of postoperative simultaneous modulated accelerated radiotherapy (SMART) for patients with head-and-neck squamous cell carcinoma (HNSCC).
  
  
  METHODS
  Between February 2003 and September 2008, 51 patients with histologically confirmed HNSCC received postoperative intensity-modulated radiotherapy (N=33) or helical tomotherapy (N=18) using SMART after curative surgical resection. The sites included were the oral cavity (OC), oropharynx (OP), larynx, and hypopharynx in 23, 20, 5, and 3 patients, respectively.
  
  
  RESULTS
  The median follow-up duration of all patients and surviving patients were 32 (range, 5-78 months) and 39 months (range, 9-77 months), respectively. The 3-year overall survival, cause-specific survival, disease-free survival, locoregional recurrence-free survival (LRRFS), and distant metastasis-free survival (DMFS) in all patients were 71%, 77%, 75%, 85%, and 82%, respectively. Although no significant difference in 3-year LRRFS were found between OC (82%) and OP (82%) carcinomas, the 3-year DMFS was worse in cases of OC (66%) carcinoma compared with OP carcinoma (95%; p=0.0414). Acute Grade 3 dermatitis, mucositis, and esophagitis occurred in 10%, 10%, and 2% of patients, respectively. At the last follow-up, Grade 3 xerostomia was documented in 10% of the patients. Young age (≤40 years) (p<0.001) and OC carcinoma primary (p=0.0142) were poor risk factors on univariate analysis for DMFS.
  
  
  CONCLUSIONS
  Postoperative SMART was observed to be effective and safe in patients with HNSCC.
authors: Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
authors: Sung Ho
authors: SH
authors: Moon
authors: Yuh-Seog
authors: YS
authors: Jung
authors: Jun Sun
authors: JS
authors: Ryu
authors: Sung Weon
authors: SW
authors: Choi
authors: Joo Yong
authors: JY
authors: Park
authors: Tak
authors: T
authors: Yun
authors: Sang Hyun
authors: SH
authors: Lee
authors: Kwan Ho
authors: KH
authors: Cho
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D002277:Carcinoma / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D002294:Carcinoma, Squamous Cell; D018572:Disease-Free Survival; D004941:Esophagitis / Q000209:etiology / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D007822:Laryngeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D018307:Neoplasms, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D009959:Oropharyngeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D011855:Radiodermatitis / Q000209:etiology / Q000473:pathology; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects / Q000379:methods*; D000077195:Squamous Cell Carcinoma of Head and Neck; D047368:Tumor Burden; D014987:Xerostomia / Q000209:etiology; D055815:Young Adult