ISSN: 1859 - 2872
Three year-survival outcomes of loco-regionally advanced head and neck cancers treated with definitive chemoradiation using volumetric-modulated arc therapy at Vinmec Times City Hospital
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Abstract
Objective: To evaluate the efficacy and toxicities of definitive radiation therapy using Volumetric Modulated Arc Therapy (VMAT) for head and neck cancer at Vinmec Times City International Hospital. Subject and method: We performed a retrospectively descriptive study on patients diagnosed with loco-regional head and neck cancer (from nasopharynx, oropharynx, hypopharynx, and larynx) with the indication for definitive radiotherapy from January 2015 to November 2022. The patients received radiotherapy by VMAT technique, with radical dose of 66-70Gy, in 33-35 fractions of 2Gy. Treatment outcomes including response, survival, and radiation-induced toxicities were collected. Result: 40 patients were included in our study with an average age of 59.3, the male/female participants ratio was 2.3. The proportion of patients with nasopharyngeal, oropharyngeal and hypopharyngeal cancer in the study were 67.5%, 7.5% and 25% respectively. Stage distribution for stage I-II. III and IV were 20%, 37.5% and 42.5%, in the order given. 100% of patients completed the radiation plan with definitive dose (66-70Gy). The response rate to treatment was 90%, of which the complete response rate was 62.5%. After a median follow-up of 33.1 months (5.3-73.5 months), the 3-year overall survival (OS) and progression free survival (PFS) were 88.6% and 86.6%, respectively. Treatment related acute toxicities was mostly grade 1-2, significant grade 3 side effects included radiation dermatitis (7.5%) and mucositis (20%). The most common late toxicities were xerostomia (75%) and swallowing difficulty (45%), all of which were mild. Conclusion: Definitive radiation therapy using Volumetric Modulated Arc Therapy (VMAT) technique for head and neck cancer gives an excellent clinical outcome with acceptable acute and prolong toxicities. It should be considered as a standard radiation technique for head and neck cancer.
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References
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