18F-FDG-PET in Guided Dose-Painting with Intensity Modulated Radiotherapy in Oropharyngeal Tumours: A Phase I Study (FiGaRO)

Failure of loco-regional control is the main cause of recurrence in patients with locally advanced head and neck squamous cell carcinoma (HNSCC).[1] Relapses at the primary site are often not amenable to salvage surgery and are associated with significant morbidity and mortality.[2,3] Recurrence of the primary tumour occurs within the high-dose radiotherapy (RT) volume in up to 95.6% of cases,[4,5] suggesting a degree of radio-resistance. It is generally accepted that increasing the radiation dose can improve local control rates (LCR) due to the existence of a dose-response curve.[6] Treatment intensification strategies such as accelerated RT or altered fractionation have yielded modest increases in LCR.[7] ART-DECO, the only randomised control trial of dose-escalated IMRT plus chemotherapy in HNSCC, escalated large anatomical volumes and resulted in disappointing results for both toxicity and efficacy.[8] The need to investigate dose-escalation to well-selected tumour sub-volumes, therefore, persists.
Source: Radiotherapy and Oncology - Category: Radiology Authors: Tags: Original Article Source Type: research