Real-life efficacy of volumetric modulated arc therapy in head and neck squamous cell carcinoma

Abstract

Objectives There is paucity of data on the efficacy of volumetric modulated arc therapy (VMAT) in head and neck squamous cell carcinoma (HNSCC). The objective of the present study was to investigate outcomes and patterns of recurrence in locally advanced HNSCC treated by VMAT. Methods A retrospective study included all patients with stage III or IV HNSCC undergoing curative VMAT. Results From 2010 to 2013, 130 patients were treated for locally advanced oropharynx (n = 55; 42%), hypopharynx (n = 38; 29%), larynx (n = 22; 17%) or oral cavity (n = 15; 12%) SCC. Median age was 60 years (range, 39–85). Median follow-up was 18.1 months (range, 0–43.7). By end of follow-up, 60 patients (46%) had died. Two-year progression-free and overall survival were respectively 63.6% and 77.3% for laryngeal tumors, 60% and 60% for oral cavity tumors, 52.6% and 57.6% for oropharyngeal tumors, and 38.8% and 54.7% for hypopharyngeal tumors. Most recurrences were located within or marginal to radiation therapy fields. Conclusion This retrospective analysis is, to our knowledge, the largest study of the efficacy of VMAT in HNSCC. Recurrence patterns and outcomes were consistent with those previously reported for intensity-modulated radiotherapy.