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

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

doi:10.3390/cancers14040939

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

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

Radiation Medicine

Research output: Contribution to journal › Article › peer-review

5 Scopus citations

Abstract

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, p < 0.05) and mean PTV and GTV doses (by 15.7 ± 4.9 Gy, p < 0.01 and 17.1 ± 6.0 Gy, p < 0.01, respectively). The average HyperArc delivery was 2.8 min longer than conventional VMAT (p < 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.

Original language	English (US)
Article number	939
Journal	Cancers
Volume	14
Issue number	4
DOIs	https://doi.org/10.3390/cancers14040939
State	Published - Feb 1 2022

Keywords

HyperArc
Non-coplanar VMAT
Recurrent head and neck cancer
Reirradiation
SBRT

ASJC Scopus subject areas

Oncology
Cancer Research

Access to Document

10.3390/cancers14040939

Cite this

Woods, K. E., Ma, T. M., Cook, K. A., Morris, E. D., Gao, Y., Sheng, K., Kishan, A. U., Hegde, J. V., Felix, C., Basehart, V., Narahara, K., Shen, Z., Tenn, S., Steinberg, M. L., Chin, R. K., & Cao, M. (2022). 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, 14(4), Article 939. https://doi.org/10.3390/cancers14040939

Woods, KE, Ma, TM, Cook, KA, Morris, ED, Gao, Y, Sheng, K, Kishan, AU, Hegde, JV, Felix, C, Basehart, V, Narahara, K, Shen, Z, Tenn, S, Steinberg, ML, Chin, RK & Cao, M 2022, '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, vol. 14, no. 4, 939. https://doi.org/10.3390/cancers14040939

@article{2bf48ca8a253456ba7ba15f30557ef59,

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",

abstract = "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, p < 0.05) and mean PTV and GTV doses (by 15.7 ± 4.9 Gy, p < 0.01 and 17.1 ± 6.0 Gy, p < 0.01, respectively). The average HyperArc delivery was 2.8 min longer than conventional VMAT (p < 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.",

keywords = "HyperArc, Non-coplanar VMAT, Recurrent head and neck cancer, Reirradiation, SBRT",

author = "Woods, {Kaley E.} and Ma, {Ting Martin} and Cook, {Kiri A.} and Morris, {Eric D.} and Yu Gao and Ke Sheng and Kishan, {Amar U.} and Hegde, {John V.} and Carol Felix and Vincent Basehart and Kelsey Narahara and Zhouhuizi Shen and Stephen Tenn and Steinberg, {Michael L.} and Chin, {Robert K.} and Minsong Cao",

note = "Publisher Copyright: {\textcopyright} 2022 by the authors. Licensee MDPI, Basel, Switzerland.",

year = "2022",

month = feb,

day = "1",

doi = "10.3390/cancers14040939",

language = "English (US)",

volume = "14",

journal = "Cancers",

issn = "2072-6694",

publisher = "Multidisciplinary Digital Publishing Institute (MDPI)",

number = "4",

}

TY - JOUR

T1 - A Prospective Phase II Study of Automated Non-Coplanar VMAT for Recurrent Head and Neck Cancer

T2 - Initial Report of Feasibility, Safety, and Patient-Reported Outcomes

AU - Woods, Kaley E.

AU - Ma, Ting Martin

AU - Cook, Kiri A.

AU - Morris, Eric D.

AU - Gao, Yu

AU - Sheng, Ke

AU - Kishan, Amar U.

AU - Hegde, John V.

AU - Felix, Carol

AU - Basehart, Vincent

AU - Narahara, Kelsey

AU - Shen, Zhouhuizi

AU - Tenn, Stephen

AU - Steinberg, Michael L.

AU - Chin, Robert K.

AU - Cao, Minsong

PY - 2022/2/1

Y1 - 2022/2/1

N2 - 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, p < 0.05) and mean PTV and GTV doses (by 15.7 ± 4.9 Gy, p < 0.01 and 17.1 ± 6.0 Gy, p < 0.01, respectively). The average HyperArc delivery was 2.8 min longer than conventional VMAT (p < 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.

AB - 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, p < 0.05) and mean PTV and GTV doses (by 15.7 ± 4.9 Gy, p < 0.01 and 17.1 ± 6.0 Gy, p < 0.01, respectively). The average HyperArc delivery was 2.8 min longer than conventional VMAT (p < 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.

KW - HyperArc

KW - Non-coplanar VMAT

KW - Recurrent head and neck cancer

KW - Reirradiation

KW - SBRT

UR - http://www.scopus.com/inward/record.url?scp=85124496526&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85124496526&partnerID=8YFLogxK

U2 - 10.3390/cancers14040939

DO - 10.3390/cancers14040939

M3 - Article

AN - SCOPUS:85124496526

SN - 2072-6694

VL - 14

JO - Cancers

JF - Cancers

IS - 4

M1 - 939

ER -

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

Abstract

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this