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Dose escalation in advanced floor of the mouth cancer: a pilot study using a combination of IMRT and stereotactic boost
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SYSNO ASEP 0544016 Document Type J - Journal Article R&D Document Type Journal Article Subsidiary J Článek ve WOS Title Dose escalation in advanced floor of the mouth cancer: a pilot study using a combination of IMRT and stereotactic boost Author(s) Blažek, T. (CZ)
Zděblová Čermáková, Z. (CZ)
Knybel, L. (CZ)
Hurník, P. (CZ)
Štembírek, Jan (UZFG-Y) ORCID
Resová, K. (CZ)
Paračková, T. (CZ)
Formánek, M. (CZ)
Cvek, J. (CZ)
Soumarová, R. (CZ)Article number 122 Source Title Radiation Oncology
Roč. 16, č. 1 (2021)Number of pages 9 s. Publication form Online - E Language eng - English Country GB - United Kingdom Keywords oral cavity tumor ; floor of the mouth tumor ; CyberKnife Subject RIV EB - Genetics ; Molecular Biology OECD category Medical laboratory technology (including laboratory samples analysis R&D Projects NV19-08-00383 GA MZd - Ministry of Health (MZ) Method of publishing Open access Institutional support UZFG-Y - RVO:67985904 UT WOS 000671174100002 EID SCOPUS 85108911619 DOI 10.1186/s13014-021-01842-1 Annotation 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. Workplace Institute of Animal Physiology and Genetics Contact Jana Zásmětová, knihovna@iapg.cas.cz, Tel.: 315 639 554 Year of Publishing 2022 Electronic address https://ro-journal.biomedcentral.com/articles/10.1186/s13014-021-01842-1
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