Wang, K and Heron, DE and Flickinger, JC and Rwigema, JCM and Ferris, RL and Kubicek, GJ and Ohr, JP and Quinn, AE and Ozhasoglu, C and Branstetter, BF
(2012)
A retrospective, deformable registration analysis of the impact of PET-CT planning on patterns of failure in stereotactic body radiation therapy for recurrent head and neck cancer.
Head and Neck Oncology, 4 (1).
Abstract
Background: Stereotactic body radiation therapy (SBRT) has seen increasing use as a salvage strategy for selected patients with recurrent, previously-irradiated squamous cell carcinoma of the head and neck (rSCCHN). PET-CT may be advantageous for tumor delineation and evaluation of treatment failures in SBRT. We analyzed the patterns of failure following SBRT for rSCCHN and assessed the impact of PET-CT treatment planning on these patterns of failure. Methods: We retrospectively reviewed 96 patients with rSCCHN treated with SBRT. Seven patients (7%) were treated after surgical resection of rSCCHN and 89 patients (93%) were treated definitively. PET-CT treatment planning was used for 45 patients whereas non-PET-CT planning was used for 51 patients. Categories of failure were assigned by comparing recurrences on post-treatment scans to the planning target volume (PTV) from planning scans using the deformable registration function of VelocityAI™. Failures were defined: In-field (>75% inside PTV), Overlap (20-75% inside PTV), Marginal (<20% inside PTV but closest edge within 1cm of PTV), or Regional/Distant (more than 1cm from PTV). Results: Median follow-up was 7.4 months (range, 2.652 months). Of 96 patients, 47 (49%) developed post-SBRT failure. Failure distribution was: In-field12.3%, Overlap24.6%, Marginal36.8%, Regional/Distant26.3%. There was a significant improvement in overall failure-free survival (log rank p = 0.037) and combined Overlap/Marginal failure-free survival (log rank p = 0.037) for those receiving PET-CT planning vs. non-PET-CT planning in the overall cohort (n = 96). Analysis of the definitive SBRT subgroup (n = 89) increased the significance of these findings (overall failure: p = 0.008, Overlap/Marginal failure: p = 0.009). There were no significant differences in age, gender, time from prior radiation, dose, use of cetuximab with SBRT, tumor differentiation, and tumor volume between the PET-CT and non-PET-CT groups. Conclusions: Most failures after SBRT treatment for rSCCHN were near misses, i.e. Overlap/Marginal failures (61.4%), suggesting an opportunity to improve outcomes with more sensitive imaging. PET-CT treatment planning showed the lowest rate of overall and near miss failures and is beneficial for SBRT treatment planning. © 2012 Wang et al.; licensee BioMed Central Ltd.
Share
| Citation/Export: |
|
| Social Networking: |
|
Details
| Item Type: |
Article
|
| Status: |
Published |
| Creators/Authors: |
| Creators | Email | Pitt Username | ORCID  |
|---|
| Wang, K | | | | | Heron, DE | deh5@pitt.edu | DEH5 | | | Flickinger, JC | jflickin@pitt.edu | JFLICKIN | | | Rwigema, JCM | | | | | Ferris, RL | | | | | Kubicek, GJ | | | | | Ohr, JP | | | | | Quinn, AE | | | | | Ozhasoglu, C | | | | | Branstetter, BF | bfb1@pitt.edu | BFB1 | |
|
| Centers: |
Other Centers, Institutes, Offices, or Units > Pittsburgh Cancer Institute |
| Date: |
20 April 2012 |
| Date Type: |
Publication |
| Journal or Publication Title: |
Head and Neck Oncology |
| Volume: |
4 |
| Number: |
1 |
| DOI or Unique Handle: |
10.1186/1758-3284-4-12 |
| Schools and Programs: |
School of Medicine > Neurological Surgery
School of Medicine > Otolaryngology
School of Medicine > Radiation Oncology
School of Medicine > Radiology |
| Refereed: |
Yes |
| Article Type: |
Review |
| Date Deposited: |
19 Oct 2016 17:10 |
| Last Modified: |
04 Feb 2019 15:58 |
| URI: |
http://d-scholarship.pitt.edu/id/eprint/29919 |
Metrics
Monthly Views for the past 3 years
Plum Analytics
Altmetric.com
Actions (login required)
 |
View Item |
![[img]](https://d-scholarship.pitt.edu/style/images/fileicons/text_plain.png)
![[feed]](/images/feed-icon-32x32.png){kind=icon}