• Je něco špatně v tomto záznamu ?

Dose escalation in advanced floor of the mouth cancer: a pilot study using a combination of IMRT and stereotactic boost

T. Blažek, Z. Zděblová Čermáková, L. Knybel, P. Hurník, J. Štembírek, K. Resová, T. Paračková, M. Formánek, J. Cvek, R. Soumarová

. 2021 ; 16 (1) : 122. [pub] 20210629

Jazyk angličtina Země Velká Británie

Typ dokumentu klinické zkoušky, časopisecké články

Perzistentní odkaz   https://www.medvik.cz/link/bmc22012387

Grantová podpora
NV19-08-00383 Ministerstvo Zdravotnictví Ceské Republiky
SGS14/LF/2017-2018 Ostravská Univerzita v Ostravě

PURPOSE: We evaluated the efficiency and toxicity of stereotactic hypofractionated boost in combination with conventionally fractionated radiotherapy in the treatment of advanced floor of the mouth cancer. METHODS: Thirty-seven patients with advanced stage of the floor of the mouth cancer, histologically confirmed squamous cell carcinoma (p16 negative) ineligible for surgical treatment, were indicated for radiochemotherapy or hyperfractionated accelerated radiotherapy (HART). The radiotherapy protocol combined external beam radiotherapy (EBRT) and a stereotactic hypofractionated boost to the primary tumor. The dose delivered from EBRT was 70-72.5 Gy in 35/50 fractions. The hypofractionated boost followed with 10 Gy in two fractions. For the variables-tumor volume, stage and grade a multivariate analysis was performed to find the relationship between overall survival, local progression and metastasis. Toxicity was evaluated according to CTCAE scale version 4. RESULTS: After a median follow-up of 16 months, 23 patients (62%) achieved complete remission. The median time to local progression and metastasis was 7 months. Local control (LC) at 2 and 5-years was 70% and 62%, respectively. Progression-free survival (PFS) and overall survival (OS) were 57% and 49% at 2 years and 41% and 27% at 5 years, respectively. Statistical analysis revealed that larger tumors had worse overall survival and a greater chance of metastasis. Log-Rank GTV > 44 ccm (HR = 1.96; [95% CI (0.87; 4.38)]; p = 0.11). No boost-related severe acute toxicity was observed. Late osteonecrosis was observed in 3 patients (8%). CONCLUSION: The combination of EBRT and stereotactic hypofractionated boost is safe and seems to be an effective option for dose escalation in patients with advanced floor of the mouth tumors who are ineligible for surgical treatment and require a non-invasive approach.

Citace poskytuje Crossref.org

000      
00000naa a2200000 a 4500
001      
bmc22012387
003      
CZ-PrNML
005      
20220506130753.0
007      
ta
008      
220425s2021 xxk f 000 0|eng||
009      
AR
024    7_
$a 10.1186/s13014-021-01842-1 $2 doi
035    __
$a (PubMed)34187494
040    __
$a ABA008 $b cze $d ABA008 $e AACR2
041    0_
$a eng
044    __
$a xxk
100    1_
$a Blažek, Tomáš $u Department of Oncology, University Hospital Ostrava, Ostrava, Czech Republic $u Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic $u 3Rd Faculty of Medicine, Charles University Prague, Prague, Czech Republic $1 https://orcid.org/0000000184059568
245    10
$a Dose escalation in advanced floor of the mouth cancer: a pilot study using a combination of IMRT and stereotactic boost / $c T. Blažek, Z. Zděblová Čermáková, L. Knybel, P. Hurník, J. Štembírek, K. Resová, T. Paračková, M. Formánek, J. Cvek, R. Soumarová
520    9_
$a PURPOSE: We evaluated the efficiency and toxicity of stereotactic hypofractionated boost in combination with conventionally fractionated radiotherapy in the treatment of advanced floor of the mouth cancer. METHODS: Thirty-seven patients with advanced stage of the floor of the mouth cancer, histologically confirmed squamous cell carcinoma (p16 negative) ineligible for surgical treatment, were indicated for radiochemotherapy or hyperfractionated accelerated radiotherapy (HART). The radiotherapy protocol combined external beam radiotherapy (EBRT) and a stereotactic hypofractionated boost to the primary tumor. The dose delivered from EBRT was 70-72.5 Gy in 35/50 fractions. The hypofractionated boost followed with 10 Gy in two fractions. For the variables-tumor volume, stage and grade a multivariate analysis was performed to find the relationship between overall survival, local progression and metastasis. Toxicity was evaluated according to CTCAE scale version 4. RESULTS: After a median follow-up of 16 months, 23 patients (62%) achieved complete remission. The median time to local progression and metastasis was 7 months. Local control (LC) at 2 and 5-years was 70% and 62%, respectively. Progression-free survival (PFS) and overall survival (OS) were 57% and 49% at 2 years and 41% and 27% at 5 years, respectively. Statistical analysis revealed that larger tumors had worse overall survival and a greater chance of metastasis. Log-Rank GTV > 44 ccm (HR = 1.96; [95% CI (0.87; 4.38)]; p = 0.11). No boost-related severe acute toxicity was observed. Late osteonecrosis was observed in 3 patients (8%). CONCLUSION: The combination of EBRT and stereotactic hypofractionated boost is safe and seems to be an effective option for dose escalation in patients with advanced floor of the mouth tumors who are ineligible for surgical treatment and require a non-invasive approach.
650    _2
$a dospělí $7 D000328
650    _2
$a senioři $7 D000368
650    _2
$a senioři nad 80 let $7 D000369
650    _2
$a spinocelulární karcinom $x mortalita $x patologie $x radioterapie $7 D002294
650    _2
$a chemoradioterapie $7 D059248
650    _2
$a kombinovaná terapie $7 D003131
650    _2
$a progrese nemoci $7 D018450
650    12
$a frakcionace dávky záření $7 D019583
650    _2
$a studie proveditelnosti $7 D005240
650    _2
$a ženské pohlaví $7 D005260
650    _2
$a následné studie $7 D005500
650    _2
$a lidé $7 D006801
650    _2
$a mužské pohlaví $7 D008297
650    _2
$a lidé středního věku $7 D008875
650    _2
$a nádory úst $x mortalita $x patologie $x radioterapie $7 D009062
650    _2
$a pilotní projekty $7 D010865
650    _2
$a radiochirurgie $x metody $7 D016634
650    _2
$a radioterapie s modulovanou intenzitou $x metody $7 D050397
650    _2
$a tumor burden $7 D047368
651    _2
$a Česká republika $x epidemiologie $7 D018153
655    _2
$a klinické zkoušky $7 D016430
655    _2
$a časopisecké články $7 D016428
700    1_
$a Zděblová Čermáková, Zuzana $u Department of Oncology, University Hospital Ostrava, Ostrava, Czech Republic. zuzana.zdeblova.cermakova@fno.cz $u Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic. zuzana.zdeblova.cermakova@fno.cz $1 https://orcid.org/0000000286683732
700    1_
$a Knybel, Lukáš $u Department of Oncology, University Hospital Ostrava, Ostrava, Czech Republic $1 https://orcid.org/0000000224616606
700    1_
$a Hurník, Pavel $u Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic $u Department of Pathology, University Hospital Ostrava, Ostrava, Czech Republic $1 https://orcid.org/0000000199137039
700    1_
$a Štembírek, Jan $u Department of Oral and Maxillofacial Surgery, University Hospital Ostrava, Ostrava, Czech Republic $u Institute of Animal Physiology and Genetics, Czech Academy of Sciences, Brno, Czech Republic $1 https://orcid.org/0000000219743096
700    1_
$a Resová, Kamila $u Department of Oncology, University Hospital Ostrava, Ostrava, Czech Republic $u Faculty of Medicine, Palacký University Olomouc, Olomouc, Czech Republic $1 https://orcid.org/0000000206569084
700    1_
$a Paračková, Tereza $u Department of Oncology, University Hospital Ostrava, Ostrava, Czech Republic $u Faculty of Medicine, Palacký University Olomouc, Olomouc, Czech Republic $1 https://orcid.org/0000000289882286
700    1_
$a Formánek, Martin $u Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic $u Department of Otorhinolaryngology, University Hospital Ostrava, Ostrava, Czech Republic $1 https://orcid.org/0000000257592073
700    1_
$a Cvek, Jakub $u Department of Oncology, University Hospital Ostrava, Ostrava, Czech Republic $u Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic $1 https://orcid.org/0000000315791792
700    1_
$a Soumarová, Renata $u 3Rd Faculty of Medicine, Charles University Prague, Prague, Czech Republic $u Department of Oncology, University Hospital Královské Vinohrady Prague, Prague, Czech Republic
773    0_
$w MED00165460 $t Radiation oncology (London, England) $x 1748-717X $g Roč. 16, č. 1 (2021), s. 122
856    41
$u https://pubmed.ncbi.nlm.nih.gov/34187494 $y Pubmed
910    __
$a ABA008 $b sig $c sign $y p $z 0
990    __
$a 20220425 $b ABA008
991    __
$a 20220506130745 $b ABA008
999    __
$a ok $b bmc $g 1789821 $s 1163588
BAS    __
$a 3
BAS    __
$a PreBMC
BMC    __
$a 2021 $b 16 $c 1 $d 122 $e 20210629 $i 1748-717X $m Radiation oncology $n Radiat. oncol. $x MED00165460
GRA    __
$a NV19-08-00383 $p Ministerstvo Zdravotnictví Ceské Republiky
GRA    __
$a SGS14/LF/2017-2018 $p Ostravská Univerzita v Ostravě
LZP    __
$a Pubmed-20220425

Najít záznam

Citační ukazatele

Možnosti archivace