Real-life assessment of Volumetric Modulated Arc Therapy (VMAT) toxicity in Head and Neck Squamous Cell Carcinoma (HNSCC) treatment.
CONCLUSIONS
The present study demonstrates the feasibility of VMAT in association with platin or cetuximab in HNSCC and reports VMAT-related acute and late toxicities for the first time.


OBJECTIVE
New radiotherapy techniques, such as Volumetric Modulated Arc Therapy (VMAT) were developed to lower RT-related toxicity. The aim of the present study was to investigate acute and late toxicities of head and neck squamous cell carcinoma (HNSCC) patients treated using VMAT.


METHODS
This study investigated retrospectively all patients with HNSCC who received VMAT in curative intent.


RESULTS
From 2010-2013, 150 patients were treated. Seventy-five patients (50%) received concurrent chemotherapy with VMAT, 51 patients (34%) received VMAT alone and 24 patients (16%) received concurrent cetuximab with VMAT. Mean delivered dose to planning target volume tumor (PTV T), high risk nodes (PTV HNR), low risk nodes (PTV LNR) and prophylactic nodes (PTV PN) were: 65.2 Gy, 62.9 Gy, 55.4 Gy, and 51.5 Gy, respectively. PTV mean coverages were higher than 96.5%. Most common grade 3/4 acute infield toxicities were mucosis (n = 28, 19%), dysphagia (n = 24, 16%), and dermatitis (n = 24, 16%). With a median follow-up of 16.0 months, most common late toxicities were dysphagia (n = 30, 20%), xerostomia (n = 28, 19%), larynx stiff (n = 17, 11%), and skin fibrosis (n = 14, 9%).
a Department of Radiotherapy , Lucien Neuwirth Cancer Institute, Saint Priest en Jarez , France.
Coralie
C
Moncharmont
a Department of Radiotherapy , Lucien Neuwirth Cancer Institute, Saint Priest en Jarez , France.
Alexis
A
Vallard
a Department of Radiotherapy , Lucien Neuwirth Cancer Institute, Saint Priest en Jarez , France.
Sylvie
S
Mengue Ndong
a Department of Radiotherapy , Lucien Neuwirth Cancer Institute, Saint Priest en Jarez , France.
Jean-Baptiste
JB
Guy
a Department of Radiotherapy , Lucien Neuwirth Cancer Institute, Saint Priest en Jarez , France.
Claire
C
Saget
b Department of Medical Oncology , Lucien Neuwirth Cancer Institute, Saint Priest en Jarez , France.
Benoîte
B
Méry
a Department of Radiotherapy , Lucien Neuwirth Cancer Institute, Saint Priest en Jarez , France.
Julien
J
Langrand-Escure
a Department of Radiotherapy , Lucien Neuwirth Cancer Institute, Saint Priest en Jarez , France.
Guy
G
de Laroche
c Department of Medical Physics , Lucien Neuwirth Cancer Institute , Saint-Priest en Jarez , France.
Dominique
D
Goyet
d Department of Otolaryngology Head and Neck Surgery , University Hospital Center , Saint Etienne , France.
Jean-Michel
JM
Prades
b Department of Medical Oncology , Lucien Neuwirth Cancer Institute, Saint Priest en Jarez , France.
Pierre
P
Fournel
a Department of Radiotherapy , Lucien Neuwirth Cancer Institute, Saint Priest en Jarez , France.
Nicolas
N
Magné
D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy*; D019583:Dose Fractionation, Radiation; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006258:Head and Neck Neoplasms / Q000188:drug therapy*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011832:Radiation Injuries / Q000453:epidemiology* / Q000517:prevention & control; D011879:Radiotherapy Dosage; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects*; D012189:Retrospective Studies; D000077195:Squamous Cell Carcinoma of Head and Neck
Acute toxicity; chemoradiotherapy; head and neck neoplasms; late toxicity; volumetric-modulated arc therapy