A Prospective Phase II Study of Automated Non-Coplanar VMAT for Recurrent Head and Neck Cancer: Initial Report of Feasibility, Safety, and Patient-Reported Outcomes
This study reports the initial results for the first 15 patients on a prospective phase II clinical trial exploring the safety, feasibility, and efficacy of the HyperArc technique for recurrent head and neck cancer treatment. Eligible patients were simulated and planned with both conventional VMAT a...
| Main Authors: | , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-02-01
|
| Series: | Cancers |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2072-6694/14/4/939 |
| _version_ | 1797482106451918848 |
|---|---|
| author | Kaley E. Woods Ting Martin Ma Kiri A. Cook Eric D. Morris Yu Gao Ke Sheng Amar U. Kishan John V. Hegde Carol Felix Vincent Basehart Kelsey Narahara Zhouhuizi Shen Stephen Tenn Michael L. Steinberg Robert K. Chin Minsong Cao |
| author_facet | Kaley E. Woods Ting Martin Ma Kiri A. Cook Eric D. Morris Yu Gao Ke Sheng Amar U. Kishan John V. Hegde Carol Felix Vincent Basehart Kelsey Narahara Zhouhuizi Shen Stephen Tenn Michael L. Steinberg Robert K. Chin Minsong Cao |
| author_sort | Kaley E. Woods |
| collection | DOAJ |
| description | This study reports the initial results for the first 15 patients on a prospective phase II clinical trial exploring the safety, feasibility, and efficacy of the HyperArc technique for recurrent head and neck cancer treatment. Eligible patients were simulated and planned with both conventional VMAT and HyperArc techniques and the plan with superior dosimetry was selected for treatment. Dosimetry, delivery feasibility and safety, treatment-related toxicity, and patient-reported quality of life (QOL) were all evaluated. HyperArc was chosen over conventional VMAT for all 15 patients and enabled statistically significant increases in dose conformity (R50% reduced by 1.2 ± 2.1, <i>p</i> < 0.05) and mean PTV and GTV doses (by 15.7 ± 4.9 Gy, <i>p</i> < 0.01 and 17.1 ± 6.0 Gy, <i>p</i> < 0.01, respectively). The average HyperArc delivery was 2.8 min longer than conventional VMAT (<i>p</i> < 0.01), and the mean intrafraction motion was ≤ 0.5 ± 0.4 mm and ≤0.3 ± 0.1°. With a median follow-up of 12 months, treatment-related toxicity was minimal (only one grade 3 acute toxicity above baseline) and patient-reported QOL metrics were favorable. HyperArc enabled superior dosimetry and significant target dose escalation compared to conventional VMAT planning, and treatment delivery was feasible, safe, and well-tolerated by patients. |
| first_indexed | 2024-03-09T22:24:34Z |
| format | Article |
| id | doaj.art-e234521877ae4c139af3dc7ba843658e |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-09T22:24:34Z |
| publishDate | 2022-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-e234521877ae4c139af3dc7ba843658e2023-11-23T19:08:52ZengMDPI AGCancers2072-66942022-02-0114493910.3390/cancers14040939A Prospective Phase II Study of Automated Non-Coplanar VMAT for Recurrent Head and Neck Cancer: Initial Report of Feasibility, Safety, and Patient-Reported OutcomesKaley E. Woods0Ting Martin Ma1Kiri A. Cook2Eric D. Morris3Yu Gao4Ke Sheng5Amar U. Kishan6John V. Hegde7Carol Felix8Vincent Basehart9Kelsey Narahara10Zhouhuizi Shen11Stephen Tenn12Michael L. Steinberg13Robert K. Chin14Minsong Cao15Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA 90095, USADepartment of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA 90095, USADepartment of Radiation Oncology, Oregon Health & Science University, Portland, OR 97239, USADepartment of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA 90095, USADepartment of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA 90095, USADepartment of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA 90095, USADepartment of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA 90095, USADepartment of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA 90095, USADepartment of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA 90095, USADepartment of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA 90095, USADepartment of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA 90095, USADepartment of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA 90095, USADepartment of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA 90095, USADepartment of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA 90095, USADepartment of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA 90095, USADepartment of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA 90095, USAThis study reports the initial results for the first 15 patients on a prospective phase II clinical trial exploring the safety, feasibility, and efficacy of the HyperArc technique for recurrent head and neck cancer treatment. Eligible patients were simulated and planned with both conventional VMAT and HyperArc techniques and the plan with superior dosimetry was selected for treatment. Dosimetry, delivery feasibility and safety, treatment-related toxicity, and patient-reported quality of life (QOL) were all evaluated. HyperArc was chosen over conventional VMAT for all 15 patients and enabled statistically significant increases in dose conformity (R50% reduced by 1.2 ± 2.1, <i>p</i> < 0.05) and mean PTV and GTV doses (by 15.7 ± 4.9 Gy, <i>p</i> < 0.01 and 17.1 ± 6.0 Gy, <i>p</i> < 0.01, respectively). The average HyperArc delivery was 2.8 min longer than conventional VMAT (<i>p</i> < 0.01), and the mean intrafraction motion was ≤ 0.5 ± 0.4 mm and ≤0.3 ± 0.1°. With a median follow-up of 12 months, treatment-related toxicity was minimal (only one grade 3 acute toxicity above baseline) and patient-reported QOL metrics were favorable. HyperArc enabled superior dosimetry and significant target dose escalation compared to conventional VMAT planning, and treatment delivery was feasible, safe, and well-tolerated by patients.https://www.mdpi.com/2072-6694/14/4/939HyperArcSBRTreirradiationrecurrent head and neck cancernon-coplanar VMAT |
| spellingShingle | Kaley E. Woods Ting Martin Ma Kiri A. Cook Eric D. Morris Yu Gao Ke Sheng Amar U. Kishan John V. Hegde Carol Felix Vincent Basehart Kelsey Narahara Zhouhuizi Shen Stephen Tenn Michael L. Steinberg Robert K. Chin Minsong Cao A Prospective Phase II Study of Automated Non-Coplanar VMAT for Recurrent Head and Neck Cancer: Initial Report of Feasibility, Safety, and Patient-Reported Outcomes Cancers HyperArc SBRT reirradiation recurrent head and neck cancer non-coplanar VMAT |
| title | A Prospective Phase II Study of Automated Non-Coplanar VMAT for Recurrent Head and Neck Cancer: Initial Report of Feasibility, Safety, and Patient-Reported Outcomes |
| title_full | A Prospective Phase II Study of Automated Non-Coplanar VMAT for Recurrent Head and Neck Cancer: Initial Report of Feasibility, Safety, and Patient-Reported Outcomes |
| title_fullStr | A Prospective Phase II Study of Automated Non-Coplanar VMAT for Recurrent Head and Neck Cancer: Initial Report of Feasibility, Safety, and Patient-Reported Outcomes |
| title_full_unstemmed | A Prospective Phase II Study of Automated Non-Coplanar VMAT for Recurrent Head and Neck Cancer: Initial Report of Feasibility, Safety, and Patient-Reported Outcomes |
| title_short | A Prospective Phase II Study of Automated Non-Coplanar VMAT for Recurrent Head and Neck Cancer: Initial Report of Feasibility, Safety, and Patient-Reported Outcomes |
| title_sort | prospective phase ii study of automated non coplanar vmat for recurrent head and neck cancer initial report of feasibility safety and patient reported outcomes |
| topic | HyperArc SBRT reirradiation recurrent head and neck cancer non-coplanar VMAT |
| url | https://www.mdpi.com/2072-6694/14/4/939 |
| work_keys_str_mv | AT kaleyewoods aprospectivephaseiistudyofautomatednoncoplanarvmatforrecurrentheadandneckcancerinitialreportoffeasibilitysafetyandpatientreportedoutcomes AT tingmartinma aprospectivephaseiistudyofautomatednoncoplanarvmatforrecurrentheadandneckcancerinitialreportoffeasibilitysafetyandpatientreportedoutcomes AT kiriacook aprospectivephaseiistudyofautomatednoncoplanarvmatforrecurrentheadandneckcancerinitialreportoffeasibilitysafetyandpatientreportedoutcomes AT ericdmorris aprospectivephaseiistudyofautomatednoncoplanarvmatforrecurrentheadandneckcancerinitialreportoffeasibilitysafetyandpatientreportedoutcomes AT yugao aprospectivephaseiistudyofautomatednoncoplanarvmatforrecurrentheadandneckcancerinitialreportoffeasibilitysafetyandpatientreportedoutcomes AT kesheng aprospectivephaseiistudyofautomatednoncoplanarvmatforrecurrentheadandneckcancerinitialreportoffeasibilitysafetyandpatientreportedoutcomes AT amarukishan aprospectivephaseiistudyofautomatednoncoplanarvmatforrecurrentheadandneckcancerinitialreportoffeasibilitysafetyandpatientreportedoutcomes AT johnvhegde aprospectivephaseiistudyofautomatednoncoplanarvmatforrecurrentheadandneckcancerinitialreportoffeasibilitysafetyandpatientreportedoutcomes AT carolfelix aprospectivephaseiistudyofautomatednoncoplanarvmatforrecurrentheadandneckcancerinitialreportoffeasibilitysafetyandpatientreportedoutcomes AT vincentbasehart aprospectivephaseiistudyofautomatednoncoplanarvmatforrecurrentheadandneckcancerinitialreportoffeasibilitysafetyandpatientreportedoutcomes AT kelseynarahara aprospectivephaseiistudyofautomatednoncoplanarvmatforrecurrentheadandneckcancerinitialreportoffeasibilitysafetyandpatientreportedoutcomes AT zhouhuizishen aprospectivephaseiistudyofautomatednoncoplanarvmatforrecurrentheadandneckcancerinitialreportoffeasibilitysafetyandpatientreportedoutcomes AT stephentenn aprospectivephaseiistudyofautomatednoncoplanarvmatforrecurrentheadandneckcancerinitialreportoffeasibilitysafetyandpatientreportedoutcomes AT michaellsteinberg aprospectivephaseiistudyofautomatednoncoplanarvmatforrecurrentheadandneckcancerinitialreportoffeasibilitysafetyandpatientreportedoutcomes AT robertkchin aprospectivephaseiistudyofautomatednoncoplanarvmatforrecurrentheadandneckcancerinitialreportoffeasibilitysafetyandpatientreportedoutcomes AT minsongcao aprospectivephaseiistudyofautomatednoncoplanarvmatforrecurrentheadandneckcancerinitialreportoffeasibilitysafetyandpatientreportedoutcomes AT kaleyewoods prospectivephaseiistudyofautomatednoncoplanarvmatforrecurrentheadandneckcancerinitialreportoffeasibilitysafetyandpatientreportedoutcomes AT tingmartinma prospectivephaseiistudyofautomatednoncoplanarvmatforrecurrentheadandneckcancerinitialreportoffeasibilitysafetyandpatientreportedoutcomes AT kiriacook prospectivephaseiistudyofautomatednoncoplanarvmatforrecurrentheadandneckcancerinitialreportoffeasibilitysafetyandpatientreportedoutcomes AT ericdmorris prospectivephaseiistudyofautomatednoncoplanarvmatforrecurrentheadandneckcancerinitialreportoffeasibilitysafetyandpatientreportedoutcomes AT yugao prospectivephaseiistudyofautomatednoncoplanarvmatforrecurrentheadandneckcancerinitialreportoffeasibilitysafetyandpatientreportedoutcomes AT kesheng prospectivephaseiistudyofautomatednoncoplanarvmatforrecurrentheadandneckcancerinitialreportoffeasibilitysafetyandpatientreportedoutcomes AT amarukishan prospectivephaseiistudyofautomatednoncoplanarvmatforrecurrentheadandneckcancerinitialreportoffeasibilitysafetyandpatientreportedoutcomes AT johnvhegde prospectivephaseiistudyofautomatednoncoplanarvmatforrecurrentheadandneckcancerinitialreportoffeasibilitysafetyandpatientreportedoutcomes AT carolfelix prospectivephaseiistudyofautomatednoncoplanarvmatforrecurrentheadandneckcancerinitialreportoffeasibilitysafetyandpatientreportedoutcomes AT vincentbasehart prospectivephaseiistudyofautomatednoncoplanarvmatforrecurrentheadandneckcancerinitialreportoffeasibilitysafetyandpatientreportedoutcomes AT kelseynarahara prospectivephaseiistudyofautomatednoncoplanarvmatforrecurrentheadandneckcancerinitialreportoffeasibilitysafetyandpatientreportedoutcomes AT zhouhuizishen prospectivephaseiistudyofautomatednoncoplanarvmatforrecurrentheadandneckcancerinitialreportoffeasibilitysafetyandpatientreportedoutcomes AT stephentenn prospectivephaseiistudyofautomatednoncoplanarvmatforrecurrentheadandneckcancerinitialreportoffeasibilitysafetyandpatientreportedoutcomes AT michaellsteinberg prospectivephaseiistudyofautomatednoncoplanarvmatforrecurrentheadandneckcancerinitialreportoffeasibilitysafetyandpatientreportedoutcomes AT robertkchin prospectivephaseiistudyofautomatednoncoplanarvmatforrecurrentheadandneckcancerinitialreportoffeasibilitysafetyandpatientreportedoutcomes AT minsongcao prospectivephaseiistudyofautomatednoncoplanarvmatforrecurrentheadandneckcancerinitialreportoffeasibilitysafetyandpatientreportedoutcomes |