title: [Recurrence sites following definitive intensity-modulated conformational radiotherapy of squamous-cell carcinomas of the upper aerodigestive tract].
abstract: OBJECTIVE
  The implementation of intensity-modulated radiotherapy (IMRT) in a centre requires regular critical review of medical practices and feedback to optimize the subsequent management of patients.
  
  
  METHODS
  We reviewed and determined through a retrospective single-centre study recurrence sites of 167 consecutive patients treated for head and neck squamous cell carcinoma excluding skin or sinuses. Patients had mostly stage III or IV locally advanced cancer (n=123).
  
  
  RESULTS
  Locoregional control rates at 1 and 2 years were respectively 87.9% (95% confidence interval [95%CI]: 81.6%-92.1%) and 77.6% (95%CI: 70.1%-83.5). Among 55 relapses, 20 patients (36.4%) had treatment failures. Patients treated with 70 Gy relapsed mainly in high risk volume (78%). Those treated with 66 Gy recurred regionally outside the irradiated volume (n=4) or in the irradiated high risk volume (n=3) or had isolated metastatic failure (n=3). Those irradiated with 50 Gy had regional relapse outside the irradiated volume (n=2) or isolated metastatic relapse (n=2). We noticed respectively 5.4%, 10.2% and 4.2% isolated metastatic, local, cervical lymph node relapse.
  
  
  CONCLUSIONS
  Our results are consistent with data from the literature. Corrective actions were performed to enhance our practices.
authors.affiliation: Département de radiothérapie, institut de cancérologie de l'Ouest Paul-Papin, 2, rue Moll, 49933 Angers cedex 9, France. Electronic address: senyo@wanadoo.fr.
authors.forename: S
authors.initials: S
authors.lastname: Yossi
authors.affiliation: Département de radiothérapie, institut de cancérologie de l'Ouest Paul-Papin, 2, rue Moll, 49933 Angers cedex 9, France; Département de radiothérapie, centre hospitalier universitaire de Marrakech, Marrakech, Maroc.
authors.forename: C
authors.initials: C
authors.lastname: El Alouani
authors.affiliation: Centre Jean-Bernard-clinique Victor-Hugo, 9, rue Beauverger, 72000 Le Mans, France.
authors.forename: Y
authors.initials: Y
authors.lastname: Pointreau
authors.affiliation: Service d'ORL et de chirurgie maxillofaciale, centre hospitalier universitaire d'Angers, 4, rue Larrey, 49100 Angers, France.
authors.forename: L
authors.initials: L
authors.lastname: Laccourreye
authors.affiliation: Département d'oncologie médicale, institut de cancérologie de l'Ouest Paul-Papin, 2, rue Moll, 49933 Angers cedex 9, France.
authors.forename: O
authors.initials: O
authors.lastname: Capitain
authors.affiliation: Département de radiothérapie, institut de cancérologie de l'Ouest Paul-Papin, 2, rue Moll, 49933 Angers cedex 9, France.
authors.forename: P
authors.initials: P
authors.lastname: Gustin
authors.affiliation: Département de radiothérapie, institut de cancérologie de l'Ouest Paul-Papin, 2, rue Moll, 49933 Angers cedex 9, France.
authors.forename: G
authors.initials: G
authors.lastname: Peyraga
authors.affiliation: Délégation à la recherche clinique et à l'innovation, institut de cancérologie de l'Ouest Paul-Papin, 2, rue Moll, 49933 Angers cedex 9, France.
authors.forename: A-L
authors.initials: AL
authors.lastname: Septans
authors.affiliation: Département de radiothérapie, institut de cancérologie de l'Ouest Paul-Papin, 2, rue Moll, 49933 Angers cedex 9, France.
authors.forename: É
authors.initials: É
authors.lastname: Jadaud
authors.affiliation: Département de radiothérapie, institut de cancérologie de l'Ouest Paul-Papin, 2, rue Moll, 49933 Angers cedex 9, France.
authors.forename: S
authors.initials: S
authors.lastname: Vinchon-Petit
authors.affiliation: Département de radiothérapie, institut de cancérologie de l'Ouest Paul-Papin, 2, rue Moll, 49933 Angers cedex 9, France.
authors.forename: P
authors.initials: P
authors.lastname: Cellier
authors.affiliation: Département de physique médicale, institut de cancérologie de l'Ouest Paul-Papin, 2, rue Moll, 49933 Angers cedex 9, France.
authors.forename: D
authors.initials: D
authors.lastname: Autret
authors.affiliation: Département de radiothérapie, institut de cancérologie de l'Ouest Paul-Papin, 2, rue Moll, 49933 Angers cedex 9, France.
authors.forename: C
authors.initials: C
authors.lastname: Tuchais
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D016190:Carboplatin / Q000008:administration & dosage; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000532:radiotherapy / Q000556:secondary*; D000068818:Cetuximab; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D000077143:Docetaxel; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006258:Head and Neck Neoplasms / Q000188:drug therapy / Q000532:radiotherapy* / Q000601:surgery; D006801:Humans; D053208:Kaplan-Meier Estimate; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D009367:Neoplasm Staging; D011879:Radiotherapy Dosage; D050397:Radiotherapy, Intensity-Modulated; D012189:Retrospective Studies; D043823:Taxoids / Q000008:administration & dosage
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D043823:Taxoids; D000077143:Docetaxel; D016190:Carboplatin; D000068818:Cetuximab; D002945:Cisplatin; D005472:Fluorouracil
keywords: Failure; Head; IMRT; Intensité; Modulation; Neck; ORL; Patterns; RCMI; Radiotherapy; Radiothérapie; Rechute; Sites; VADS