Intraoperative radiotherapy for head and neck and skull base cancer

A. Daniel Pinheiro, Robert L. Foote, Thomas V. McCaffrey, Jan Kasperbauer, James A. Bonner, Kerry D. Olsen, Stephen S. Cha, Daniel J. Sargent

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Background. The purpose of this study was to evaluate the use of intraoperative electron beam radiotherapy (IORT) as an adjuvant modality in the treatment of advanced head and neck and skull base cancer. Methods. Between 1991 and 1996, 34 patients with squamous cell carcinoma (SCCA) and 10 patients with non-SCCA were enrolled in this prospective nonrandomized clinical trial. Most patients had been previously treated with combinations of surgery, external beam radiotherapy, and chemotherapy. The most frequent sites treated were the skull base (56%) and the neck (44%). IORT was delivered in a dedicated operating room suite with energies of 6 to 15 MeV (6 MeV most commonly used) at doses of 12.5 to 22.5 Gy. Results. At 2 years overall and disease-free survival was 32% and 21%, respectively, for the SCCA patients and 50% and 40%, respectively, for the non-SCCA patients. Tumor control rates at 2 years in the IORT field were 46% for the SCCA patients and 52% for the non-SCCA patients. For squamous cell histology, survival in patients with microscopic residual tumor did not differ from those with no residual tumor, but they both had significantly longer disease-free survival than those patients with gross residual at the time of IORT (p = .03), with a trend toward longer overall survival (p = .09). The only complication directly attributable to IORT was a neuropathy in a patient who received an IORT dose of 22.5 Gy (cumulative dose 130.1 Gy). Conclusions. IORT at a dose of 12.5 Gy is safe and produces tumor control and survival for patients likely to have microscopic residual disease in sites difficult to resect such as the skull base.

Original languageEnglish (US)
Pages (from-to)217-225
Number of pages9
JournalHead and Neck
Volume25
Issue number3
DOIs
StatePublished - Mar 1 2003

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Skull Base
Neck
Radiotherapy
Head
Electrons
Neoplasms
Squamous Cell Carcinoma
Residual Neoplasm
Carcinoma
Disease-Free Survival
Survival
Adjuvant Radiotherapy
Operating Rooms
Histology
Epithelial Cells
Drug Therapy

Keywords

  • Advanced cancer
  • Head and neck cancer
  • Intraoperative radiotherapy
  • Skull base
  • Squamous cell carcinoma

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Pinheiro, A. D., Foote, R. L., McCaffrey, T. V., Kasperbauer, J., Bonner, J. A., Olsen, K. D., ... Sargent, D. J. (2003). Intraoperative radiotherapy for head and neck and skull base cancer. Head and Neck, 25(3), 217-225. https://doi.org/10.1002/hed.10203

Intraoperative radiotherapy for head and neck and skull base cancer. / Pinheiro, A. Daniel; Foote, Robert L.; McCaffrey, Thomas V.; Kasperbauer, Jan; Bonner, James A.; Olsen, Kerry D.; Cha, Stephen S.; Sargent, Daniel J.

In: Head and Neck, Vol. 25, No. 3, 01.03.2003, p. 217-225.

Research output: Contribution to journalArticle

Pinheiro, AD, Foote, RL, McCaffrey, TV, Kasperbauer, J, Bonner, JA, Olsen, KD, Cha, SS & Sargent, DJ 2003, 'Intraoperative radiotherapy for head and neck and skull base cancer', Head and Neck, vol. 25, no. 3, pp. 217-225. https://doi.org/10.1002/hed.10203
Pinheiro AD, Foote RL, McCaffrey TV, Kasperbauer J, Bonner JA, Olsen KD et al. Intraoperative radiotherapy for head and neck and skull base cancer. Head and Neck. 2003 Mar 1;25(3):217-225. https://doi.org/10.1002/hed.10203
Pinheiro, A. Daniel ; Foote, Robert L. ; McCaffrey, Thomas V. ; Kasperbauer, Jan ; Bonner, James A. ; Olsen, Kerry D. ; Cha, Stephen S. ; Sargent, Daniel J. / Intraoperative radiotherapy for head and neck and skull base cancer. In: Head and Neck. 2003 ; Vol. 25, No. 3. pp. 217-225.
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AU - Pinheiro, A. Daniel

AU - Foote, Robert L.

AU - McCaffrey, Thomas V.

AU - Kasperbauer, Jan

AU - Bonner, James A.

AU - Olsen, Kerry D.

AU - Cha, Stephen S.

AU - Sargent, Daniel J.

PY - 2003/3/1

Y1 - 2003/3/1

N2 - Background. The purpose of this study was to evaluate the use of intraoperative electron beam radiotherapy (IORT) as an adjuvant modality in the treatment of advanced head and neck and skull base cancer. Methods. Between 1991 and 1996, 34 patients with squamous cell carcinoma (SCCA) and 10 patients with non-SCCA were enrolled in this prospective nonrandomized clinical trial. Most patients had been previously treated with combinations of surgery, external beam radiotherapy, and chemotherapy. The most frequent sites treated were the skull base (56%) and the neck (44%). IORT was delivered in a dedicated operating room suite with energies of 6 to 15 MeV (6 MeV most commonly used) at doses of 12.5 to 22.5 Gy. Results. At 2 years overall and disease-free survival was 32% and 21%, respectively, for the SCCA patients and 50% and 40%, respectively, for the non-SCCA patients. Tumor control rates at 2 years in the IORT field were 46% for the SCCA patients and 52% for the non-SCCA patients. For squamous cell histology, survival in patients with microscopic residual tumor did not differ from those with no residual tumor, but they both had significantly longer disease-free survival than those patients with gross residual at the time of IORT (p = .03), with a trend toward longer overall survival (p = .09). The only complication directly attributable to IORT was a neuropathy in a patient who received an IORT dose of 22.5 Gy (cumulative dose 130.1 Gy). Conclusions. IORT at a dose of 12.5 Gy is safe and produces tumor control and survival for patients likely to have microscopic residual disease in sites difficult to resect such as the skull base.

AB - Background. The purpose of this study was to evaluate the use of intraoperative electron beam radiotherapy (IORT) as an adjuvant modality in the treatment of advanced head and neck and skull base cancer. Methods. Between 1991 and 1996, 34 patients with squamous cell carcinoma (SCCA) and 10 patients with non-SCCA were enrolled in this prospective nonrandomized clinical trial. Most patients had been previously treated with combinations of surgery, external beam radiotherapy, and chemotherapy. The most frequent sites treated were the skull base (56%) and the neck (44%). IORT was delivered in a dedicated operating room suite with energies of 6 to 15 MeV (6 MeV most commonly used) at doses of 12.5 to 22.5 Gy. Results. At 2 years overall and disease-free survival was 32% and 21%, respectively, for the SCCA patients and 50% and 40%, respectively, for the non-SCCA patients. Tumor control rates at 2 years in the IORT field were 46% for the SCCA patients and 52% for the non-SCCA patients. For squamous cell histology, survival in patients with microscopic residual tumor did not differ from those with no residual tumor, but they both had significantly longer disease-free survival than those patients with gross residual at the time of IORT (p = .03), with a trend toward longer overall survival (p = .09). The only complication directly attributable to IORT was a neuropathy in a patient who received an IORT dose of 22.5 Gy (cumulative dose 130.1 Gy). Conclusions. IORT at a dose of 12.5 Gy is safe and produces tumor control and survival for patients likely to have microscopic residual disease in sites difficult to resect such as the skull base.

KW - Advanced cancer

KW - Head and neck cancer

KW - Intraoperative radiotherapy

KW - Skull base

KW - Squamous cell carcinoma

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