PDF(Pubmed)
Abstract：
BACKGROUND: It is difficult to reirradiate head and neck cancers because of the toxicity from previous radiation dose delivery. Conventional volumetric modulated arc therapy (VMAT) and intensity-modulated radiation therapy often have poor target coverage. The new HyperArcTM VMAT (HA-VMAT) planning approach reportedly has better target coverage, higher conformity, and can spare normal organs compared to conventional VMAT; however, research on recurrent head and neck cancers is limited. Here, we report the clinical outcomes of HA-VMAT for previously irradiated hypopharyngeal cancer with solitary recurrence in the first cervical vertebra (C1).
METHODS: A 52-year-old Asian male was diagnosed with a hypopharyngeal cancer. The patient received concurrent chemoradiotherapy with a radiation dose of 70 Gy in 33 fractions and achieved complete clinical response. Two years later, solitary recurrence was observed in the C1 vertebra.
METHODS: Solitary recurrence in the C1 vertebra.
METHODS: Owing to concerns regarding the toxicity to adjacent organs, we decided to use HA-VMAT to achieve better tumor coverage and critical organ sparing.
RESULTS: Tumor regression was observed on the imaging. At 9 months follow-up, the patient was disease-free and had no late toxicities.
CONCLUSIONS: This is the first report regarding the clinical outcomes of HA-VMAT for previously irradiated hypopharyngeal cancer with solitary recurrence over the C1 vertebra. HA-VMAT achieves highly conformal dose distribution and excellent sparing of critical organs. There was a favorable initial clinical response with no toxicity. Long-term follow-up is essential in such cases.
METHODS: A 52-year-old Asian male was diagnosed with a hypopharyngeal cancer. The patient received concurrent chemoradiotherapy with a radiation dose of 70 Gy in 33 fractions and achieved complete clinical response. Two years later, solitary recurrence was observed in the C1 vertebra.
METHODS: Solitary recurrence in the C1 vertebra.
METHODS: Owing to concerns regarding the toxicity to adjacent organs, we decided to use HA-VMAT to achieve better tumor coverage and critical organ sparing.
RESULTS: Tumor regression was observed on the imaging. At 9 months follow-up, the patient was disease-free and had no late toxicities.
CONCLUSIONS: This is the first report regarding the clinical outcomes of HA-VMAT for previously irradiated hypopharyngeal cancer with solitary recurrence over the C1 vertebra. HA-VMAT achieves highly conformal dose distribution and excellent sparing of critical organs. There was a favorable initial clinical response with no toxicity. Long-term follow-up is essential in such cases.
摘要：
背景：由于先前的辐射剂量递送的毒性，很难再照射头颈癌。传统的体积调制电弧治疗(VMAT)和强度调制辐射治疗通常具有较差的目标覆盖。据报道，新的HyperArcTMVMAT（HA-VMAT）计划方法具有更好的目标覆盖率，更高的一致性，与常规VMAT相比，可以节省正常器官；然而，对复发性头颈癌的研究是有限的。这里,我们报告了HA-VMAT治疗先前照射过的第一颈椎单发复发的下咽癌(C1)的临床结果.
方法：一名52岁的亚洲男性被诊断患有下咽癌。患者接受同步放化疗，辐射剂量为70Gy，分33次进行，并获得了完全的临床反应。两年后,在C1椎骨中观察到孤立性复发。
方法：C1椎体孤立性复发。
方法：由于担心对邻近器官的毒性，我们决定使用HA-VMAT来实现更好的肿瘤覆盖和关键器官保护。
结果：在成像上观察到肿瘤消退。在9个月的随访中，患者无病,无晚期毒性.
结论：这是关于HA-VMAT治疗先前照射过的下咽癌的临床结果的第一份报告。HA-VMAT实现了高度适形的剂量分布和对关键器官的出色保留。有良好的初始临床反应，没有毒性。在这种情况下，长期随访至关重要。
方法：一名52岁的亚洲男性被诊断患有下咽癌。患者接受同步放化疗，辐射剂量为70Gy，分33次进行，并获得了完全的临床反应。两年后,在C1椎骨中观察到孤立性复发。
方法：C1椎体孤立性复发。
方法：由于担心对邻近器官的毒性，我们决定使用HA-VMAT来实现更好的肿瘤覆盖和关键器官保护。
结果：在成像上观察到肿瘤消退。在9个月的随访中，患者无病,无晚期毒性.
结论：这是关于HA-VMAT治疗先前照射过的下咽癌的临床结果的第一份报告。HA-VMAT实现了高度适形的剂量分布和对关键器官的出色保留。有良好的初始临床反应，没有毒性。在这种情况下，长期随访至关重要。
