Late term tolerance in head neck cancer patients irradiated in the IMRT eraReportar como inadecuado

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Radiation Oncology

, 8:259

Clinical Radiation Oncology


BackgroundThe aim was to quantify severe transient and persisting late term effects in our single institution head neck cancer HNC cohort treated with curatively intended intensity modulated radiation therapy IMRT. Hypothesis was if a 2-year follow up FU is sufficient to estimate the long term tolerance in HNC irradiated in the IMRT era.

MethodsBetween 01-2002-8-2012, 707-1211 58% consecutively treated IMRT patients met the inclusion criteria of a FU time >12 months and loco-regional disease control LRC. 45% presented with loco-regionally advanced disease; 55% were referred for curative definitive IMRT 66 Gy-72 Gy in 30–35 fractions, 45% underwent postoperative IMRT 60-66 Gy in 30–33 fractions. Systemic concomitant therapy was administered in 85%. Highly consistent treatment procedures were performed with respect to contouring processes, dose constraints, radiation schedules, and the use of systemic therapy. Grade 3-4 late term effects were prospectively assessed and analyzed with respect to subgroups at particular risk for specific late effects.

ResultsMean-median FU of the cohort was 41-35 months 15–124. 13% of the patients 92-707 experienced any grade 3-4 late effects 101 events in 92-707 patients, 81% in the first 12 months after radiation. 4% of all developed persisting late grade 3-4 effects 25 events in 25-707 patients.

ConclusionsIMRT led to a high late term tolerance in loco-regionally disease free HNC patients. The onset of any G3-4 effects showed a plateau at 2 years. The question of the cervical vessel tolerance in disease free long time survivors is still open and currently under evaluation at our institution.

KeywordsPersistent late term effects Late term tolerance IMRT and late term effects Grade 3-4 late effects IMRT tolerance Electronic supplementary materialThe online version of this article doi:10.1186-1748-717X-8-259 contains supplementary material, which is available to authorized users.

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Autor: Gabriela Studer - Claudia Linsenmeier - Oliver Riesterer - Yousef Najafi - Michelle Brown - Bita Yousefi - Marius Bredell -


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