A systematic review on clinical adaptive radiotherapy for head and neck cancer
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A systematic review on clinical adaptive radiotherapy for head and neck cancer. / Lindegaard, Anne Marie; Håkansson, Katrin; Bernsdorf, Mogens; Gothelf, Anita B; Kristensen, Claus A; Specht, Lena; Vogelius, Ivan R; Friborg, Jeppe.
In: Acta oncologica (Stockholm, Sweden), Vol. 62, No. 11, 2023, p. 1360-1368.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - A systematic review on clinical adaptive radiotherapy for head and neck cancer
AU - Lindegaard, Anne Marie
AU - Håkansson, Katrin
AU - Bernsdorf, Mogens
AU - Gothelf, Anita B
AU - Kristensen, Claus A
AU - Specht, Lena
AU - Vogelius, Ivan R
AU - Friborg, Jeppe
PY - 2023
Y1 - 2023
N2 - INTRODUCTION: Head and neck cancer (HNC) patients' anatomy may undergo significant changes during radiotherapy (RT). This potentially affects dose distribution and compromises conformity between planned and delivered dose. Adaptive radiotherapy (ART) is a promising technique to overcome this problem but requires a significant workload. This systematic review aims to estimate the clinical and dosimetric benefits of ART using prospective data.MATERIAL AND METHODS: A search on PubMed and Web of Science according to the PRISMA guidelines was made on Feb 6, 2023. Search string used was: 'adaptive radiotherapy head neck cancer'. English language filter was applied. All studies were screened for inclusion on title and abstract, and the full text was read and discussed in the research group in case of uncertainty. Inclusion criteria were a prospective ART strategy for HNC investigating clinical or dosimetric outcomes.RESULTS: A total of 1251 articles were identified of which 15 met inclusion criteria. All included studies were published between 2010 and 2023 with a substantial diversity in design, endpoints, and nomenclature. The number of patients treated with ART was small with a median of 20 patients per study (range 4 to 86), undergoing 1-2 replannings. Mean dose to the parotid glands was reduced by 0.4-7.1 Gy. Maximum dose to the spinal cord was reduced by 0.5-4.6 Gy. Only five studies reported clinical outcome and disease control was excellent. Data on toxicity were ambiguous with some studies indicating reduced acute toxicity and xerostomia, while others found reduced quality of life in patients treated with ART.CONCLUSION: The literature on clinical ART in HNC is limited. ART is associated with small reductions in doses to organs at risk, but the influence on toxicity and disease control is uncertain. There is a clear need for larger, prospective trials with a well-defined control group.
AB - INTRODUCTION: Head and neck cancer (HNC) patients' anatomy may undergo significant changes during radiotherapy (RT). This potentially affects dose distribution and compromises conformity between planned and delivered dose. Adaptive radiotherapy (ART) is a promising technique to overcome this problem but requires a significant workload. This systematic review aims to estimate the clinical and dosimetric benefits of ART using prospective data.MATERIAL AND METHODS: A search on PubMed and Web of Science according to the PRISMA guidelines was made on Feb 6, 2023. Search string used was: 'adaptive radiotherapy head neck cancer'. English language filter was applied. All studies were screened for inclusion on title and abstract, and the full text was read and discussed in the research group in case of uncertainty. Inclusion criteria were a prospective ART strategy for HNC investigating clinical or dosimetric outcomes.RESULTS: A total of 1251 articles were identified of which 15 met inclusion criteria. All included studies were published between 2010 and 2023 with a substantial diversity in design, endpoints, and nomenclature. The number of patients treated with ART was small with a median of 20 patients per study (range 4 to 86), undergoing 1-2 replannings. Mean dose to the parotid glands was reduced by 0.4-7.1 Gy. Maximum dose to the spinal cord was reduced by 0.5-4.6 Gy. Only five studies reported clinical outcome and disease control was excellent. Data on toxicity were ambiguous with some studies indicating reduced acute toxicity and xerostomia, while others found reduced quality of life in patients treated with ART.CONCLUSION: The literature on clinical ART in HNC is limited. ART is associated with small reductions in doses to organs at risk, but the influence on toxicity and disease control is uncertain. There is a clear need for larger, prospective trials with a well-defined control group.
KW - Humans
KW - Head and Neck Neoplasms/radiotherapy
KW - Organs at Risk
KW - Prospective Studies
KW - Quality of Life
KW - Radiotherapy Dosage
KW - Radiotherapy Planning, Computer-Assisted/methods
U2 - 10.1080/0284186X.2023.2245555
DO - 10.1080/0284186X.2023.2245555
M3 - Journal article
C2 - 37560990
VL - 62
SP - 1360
EP - 1368
JO - Acta Oncologica
JF - Acta Oncologica
SN - 1100-1704
IS - 11
ER -
ID: 387698076