Evaluating the results of two years of concurrent chemotherapy and volumetric modulated arc radiation therapy for head and neck cancer at Vinmec hospital

Abstract

Object: Evaluate the results of concurrent chemotherapy in combination with volumetric modulated arc radiation therapy (VMAT/RapidArc) for the treatment of head and neck cancers, first 2 years experience at Vinmec Times City International Hospital.

Methods: Five patients treated from January 2015 to January 2017 were analyzed. Patients were treated with VMAT and SIB in 35 fractions for a total dose of 70Gy (PTV_70), 63Gy (PTV_63) and 56Gy (PTV_56), respectively. For organs at risk, the mean dose, V50Gy were analysed. For targets, Dmean, D98%, D2%, conformity and homogeneity indexes were calculated. Toxicity was graded according to CTCAE v4.0.

Results: 05 patients were treated and completed all treatment. Complete response was seen in 4 patients, 01 tonsil cancer achieved partial resonse. Grade 3 acute sequalea of somatitis, esophagitis occurred in first patient that resulted in interuption of 01 week for supportive care. Late effects were grade 1 xerostomia in 2 patients, no speech difficulty, no dysphagia and mandible pain was reported. All patients were met the radiotherapy plan compliance criteria in terms of dose calculation and quality assurance.

Conclusions: VMAT-SIB in concurrent combination with chemotherapy is safe and high efficiency in mangament of advanced stage head and neck cancers in terms of overall survival and progression-free survival with acceptable acute and late toxicities but need to enroll many more patient to confirm these findings.