IMRT dose fractionation for head and neck cancer: variation in current approaches will make standardisation difficult.

2.50
Hdl Handle:
http://hdl.handle.net/10541/69734
Title:
IMRT dose fractionation for head and neck cancer: variation in current approaches will make standardisation difficult.
Authors:
Ho, Kean F; Fowler, Jack F; Sykes, Andrew J; Yap, Beng K; Lee, Lip W; Slevin, Nicholas J ( 0000-0002-3367-7013 )
Abstract:
INTRODUCTION: Altered fractionation has demonstrated clinical benefits compared to the conventional 2 Gy/day standard of 70 Gy. When using synchronous chemotherapy, there is uncertainty about optimum fractionation. IMRT with its potential for Simultaneous Integrated Boost (SIB) adds further to this uncertainty. This survey will examine international practice of IMRT fractionation and suggest possible reasons for diversity in approach. MATERIAL AND METHODS: Fourteen international cancer centres were surveyed for IMRT dose/fractionation practised in each centre. RESULTS: Twelve different types of dose fractionation were reported. Conventional 70-72 Gy (daily 2 Gy/fraction) was used in 3/14 centres with concurrent chemotherapy while 11/14 centres used altered fractionation. Two centres used >1 schedule. Reported schedules and number of centres included 6 fractions/week DAHANCA regime (3), modest hypofractionation (< or =2.2 Gy/fraction) (3), dose-escalated hypofractionation (> or =2.3 Gy/fraction) (4), hyperfractionation (1), continuous acceleration (1) and concomitant boost (1). Reasons for dose fractionation variability include (i) dose escalation; (ii) total irradiated volume; (iii) number of target volumes; (iv) synchronous systemic treatment; (v) shorter overall treatment time; (vi) resources availability; (vii) longer time on treatment couch; (viii) variable GTV margins; (ix) confidence in treatment setup; (x) late tissue toxicity and (xi) use of lower neck anterior fields. CONCLUSIONS: This variability in IMRT fractionation makes any meaningful comparison of treatment results difficult. Some standardization is needed particularly for design of multi-centre randomized clinical trials.
Affiliation:
Academic Department of Radiation Oncology, University of Manchester, Christie Hospital, Wilmslow Road, Manchester, UK.
Citation:
IMRT dose fractionation for head and neck cancer: variation in current approaches will make standardisation difficult. 2009, 48 (3):431-9 Acta Oncol
Journal:
Acta Oncologica
Issue Date:
2009
URI:
http://hdl.handle.net/10541/69734
DOI:
10.1080/02841860802372272
PubMed ID:
18781445
Type:
Article
Language:
en
ISSN:
1651-226X
Appears in Collections:
All Christie Publications ; Clinical Oncology; Academic Department of Radiation Oncology - ADRO

Full metadata record

DC FieldValue Language
dc.contributor.authorHo, Kean F-
dc.contributor.authorFowler, Jack F-
dc.contributor.authorSykes, Andrew J-
dc.contributor.authorYap, Beng K-
dc.contributor.authorLee, Lip W-
dc.contributor.authorSlevin, Nicholas J-
dc.date.accessioned2009-06-04T14:35:00Z-
dc.date.available2009-06-04T14:35:00Z-
dc.date.issued2009-
dc.identifier.citationIMRT dose fractionation for head and neck cancer: variation in current approaches will make standardisation difficult. 2009, 48 (3):431-9 Acta Oncolen
dc.identifier.issn1651-226X-
dc.identifier.pmid18781445-
dc.identifier.doi10.1080/02841860802372272-
dc.identifier.urihttp://hdl.handle.net/10541/69734-
dc.description.abstractINTRODUCTION: Altered fractionation has demonstrated clinical benefits compared to the conventional 2 Gy/day standard of 70 Gy. When using synchronous chemotherapy, there is uncertainty about optimum fractionation. IMRT with its potential for Simultaneous Integrated Boost (SIB) adds further to this uncertainty. This survey will examine international practice of IMRT fractionation and suggest possible reasons for diversity in approach. MATERIAL AND METHODS: Fourteen international cancer centres were surveyed for IMRT dose/fractionation practised in each centre. RESULTS: Twelve different types of dose fractionation were reported. Conventional 70-72 Gy (daily 2 Gy/fraction) was used in 3/14 centres with concurrent chemotherapy while 11/14 centres used altered fractionation. Two centres used >1 schedule. Reported schedules and number of centres included 6 fractions/week DAHANCA regime (3), modest hypofractionation (< or =2.2 Gy/fraction) (3), dose-escalated hypofractionation (> or =2.3 Gy/fraction) (4), hyperfractionation (1), continuous acceleration (1) and concomitant boost (1). Reasons for dose fractionation variability include (i) dose escalation; (ii) total irradiated volume; (iii) number of target volumes; (iv) synchronous systemic treatment; (v) shorter overall treatment time; (vi) resources availability; (vii) longer time on treatment couch; (viii) variable GTV margins; (ix) confidence in treatment setup; (x) late tissue toxicity and (xi) use of lower neck anterior fields. CONCLUSIONS: This variability in IMRT fractionation makes any meaningful comparison of treatment results difficult. Some standardization is needed particularly for design of multi-centre randomized clinical trials.en
dc.language.isoenen
dc.subjectHead and Neck Canceren
dc.subject.meshDose Fractionation-
dc.subject.meshHead and Neck Neoplasms-
dc.subject.meshHumans-
dc.subject.meshRadiotherapy Dosage-
dc.subject.meshRadiotherapy Planning, Computer-Assisted-
dc.subject.meshRadiotherapy, Conformal-
dc.subject.meshRadiotherapy, Intensity-Modulated-
dc.titleIMRT dose fractionation for head and neck cancer: variation in current approaches will make standardisation difficult.en
dc.typeArticleen
dc.contributor.departmentAcademic Department of Radiation Oncology, University of Manchester, Christie Hospital, Wilmslow Road, Manchester, UK.en
dc.identifier.journalActa Oncologicaen
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