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

Cancers (Feb 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

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

Affiliations

Kaley E. Woods: Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA 90095, USA
Ting Martin Ma: Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA 90095, USA
Kiri A. Cook: Department of Radiation Oncology, Oregon Health & Science University, Portland, OR 97239, USA
Eric D. Morris: Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA 90095, USA
Yu Gao: Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA 90095, USA
Ke Sheng: Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA 90095, USA
Amar U. Kishan: Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA 90095, USA
John V. Hegde: Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA 90095, USA
Carol Felix: Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA 90095, USA
Vincent Basehart: Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA 90095, USA
Kelsey Narahara: Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA 90095, USA
Zhouhuizi Shen: Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA 90095, USA
Stephen Tenn: Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA 90095, USA
Michael L. Steinberg: Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA 90095, USA
Robert K. Chin: Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA 90095, USA
Minsong Cao: Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA 90095, USA

DOI: https://doi.org/10.3390/cancers14040939
Journal volume & issue: Vol. 14, no. 4
p. 939

Abstract

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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 p p 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.

Published in Cancers

ISSN: 2072-6694 (Online)
Publisher: MDPI AG
Country of publisher: Switzerland
LCC subjects: Medicine: Internal medicine: Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Website: https://www.mdpi.com/journal/cancers/

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