• Sung Ho Moon, Yuh-Seog Jung, Jun Sun Ryu, Sung Weon Choi, Joo Yong Park, Tak Yun, Sang Hyun Lee, and Kwan Ho Cho.
• Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
• Int. J. Radiat. Oncol. Biol. Phys. 2011 Sep 1; 81 (1): 140-9.

PurposeTo evaluate the treatment efficacy and toxicity of postoperative simultaneous modulated accelerated radiotherapy (SMART) for patients with head-and-neck squamous cell carcinoma (HNSCC).Methods And MaterialsBetween 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.ResultsThe 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.ConclusionPostoperative SMART was observed to be effective and safe in patients with HNSCC.Copyright © 2011 Elsevier Inc. All rights reserved.

61 keywords...

hide…