Cancer Research and Treatment

Original Articles

The Effect of Hospital Case Volume on Clinical Outcomes in Patients with Nasopharyngeal Carcinoma: A Multi-institutional Retrospective Analysis (KROG-1106): Boram Ha, Kwan Ho Cho, Sung Ho Moon, Chang-Geol Lee, Ki Chang Keum, Yeon-Sil Kim, Hong-Gyun Wu, Jin Ho Kim, Yong Chan Ahn, Dongryul Oh, Jae Myoung Noh, Jong Hoon Lee, Sung Hwan Kim, Won Taek Kim, Young-Taek Oh, Min Kyu Kang, Jin Hee Kim, Ji-Yoon Kim, Moon-June Cho, Chul Seoung Kay, Jin Hwa Choi; Cancer Res Treat. 2019;51(1):12-23. Published online February 5, 2018; DOI: https://doi.org/10.4143/crt.2017.273

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Purpose
The purpose of this study was to investigate the effect of hospital case volume on clinical outcomes in patients with nasopharyngeal carcinoma (NPC).
Materials and Methods
Data on 1,073 patients with cT1-4N0-3M0 NPC were collected from a multi-institutional retrospective database (KROG 11-06). All patients received definitive radiotherapy (RT) either with three-dimensional-conformal RT (3D-CRT) (n=576) or intensity-modulated RT (IMRT) (n=497). The patients were divided into two groups treated at high volume institution (HVI) (n=750) and low volume institution (LVI) (n=323), defined as patient volume ≥ 10 (median, 13; range, 10 to 18) and < 10 patients per year (median, 3; range, 2 to 6), respectively. Endpoints were overall survival (OS) and loco-regional progression-free survival (LRPFS).
Results
At a median follow-up of 56.7 months, the outcomes were significantly better in those treated at HVI than at LVI. For the 614 patients of propensity score-matched cohort, 5-year OS and LRPFS were consistently higher in the HVI group than in the LVI group (OS: 78.4% vs. 62.7%, p < 0.001; LRPFS: 86.2% vs. 65.8%, p < 0.001, respectively). According to RT modality, significant difference in 5-year OS was observed in patients receiving 3D-CRT (78.7% for HVI vs. 58.9% for LVI, p < 0.001) and not in those receiving IMRT (77.3% for HVI vs. 75.5% for LVI, p=0.170).
Conclusion
A significant relationship was observed between HVI and LVI for the clinical outcomes of patients with NPC. However, the difference in outcome becomes insignificant in the IMRT era, probably due to the standardization of practice by education.

Citations

Citations to this article as recorded by

Accumulated Dose Deviation of Rotational and Residual Setup Errors on Nasopharyngeal Carcinoma Using MIM Treated by Helical Tomotherapy
Wenyan Yao, Jiang Hu, Peixun Xu, Mengxue He, Yongwen Fang, Mingzhi Liu, Zongtai Li, Huilang He, Hui Liu, Wenzhao Sun, Senkui Xu
Technology in Cancer Research & Treatment.2023;[Epub] CrossRef
Systematic Review and Meta-analysis of the Association Between Radiation Therapy Treatment Volume and Patient Outcomes
Jerry Ye Aung Kyaw, Alice Rendall, Erin F. Gillespie, Tom Roques, Laurence Court, Yolande Lievens, Alison C. Tree, Chris Frampton, Ajay Aggarwal
International Journal of Radiation Oncology*Biology*Physics.2023; 117(5): 1063. CrossRef
The Influence of Hospital Volume on the Outcomes of Nasopharyngeal, Sinonasal, and Skull-Base Tumors: A Systematic Review of the Literature
Stephanie Flukes, Rahul K. Sharma, Shivangi Lohia, Marc A. Cohen
Journal of Neurological Surgery Part B: Skull Base.2022; 83(03): 270. CrossRef
A Comprehensive Analysis of Treatment Management and Survival Outcomes in Nasopharyngeal Carcinoma
Khodayar Goshtasbi, Brandon M. Lehrich, Jack L. Birkenbeuel, Arash Abiri, Jeremy P. Harris, Edward C. Kuan
Otolaryngology–Head and Neck Surgery.2021; 165(1): 93. CrossRef
Hospital volume and physician volume in association with survival in patients with nasopharyngeal cancer after radiation therapy
Tzu-Yu Lai, Chiu-Mei Yeh, Yu-Wen Hu, Chia-Jen Liu
Radiotherapy and Oncology.2020; 151: 190. CrossRef

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Carotid-Sparing TomoHelical 3-Dimensional Conformal Radiotherapy for Early Glottic Cancer: Chae-Seon Hong, Dongryul Oh, Sang Gyu Ju, Yong Chan Ahn, Jae Myoung Noh, Kwangzoo Chung, Jin Sung Kim, Tae-Suk Suh; Cancer Res Treat. 2016;48(1):63-70. Published online March 6, 2015; DOI: https://doi.org/10.4143/crt.2014.265

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Purpose
The purpose of this study was to investigate the dosimetric benefits and treatment efficiency of carotid-sparing TomoHelical 3-dimensional conformal radiotherapy (TH-3DCRT) for early glottic cancer. Materials and Methods Ten early-stage (T1N0M0) glottic squamous cell carcinoma patients were simulated, based on computed tomography scans. Two-field 3DCRT (2F-3DCRT), 3-field intensity-modulated radiation therapy (3F-IMRT), TomoHelical-IMRT (TH-IMRT), and TH-3DCRT plans were generated with a 67.5-Gy total prescription dose to the planning target volume (PTV) for each patient. In order to evaluate the plan quality, dosimetric characteristics were compared in terms of conformity index (CI) and homogeneity index (HI) for PTV, dose to the carotid arteries, and maximum dose to the spinal cord. Treatment planning and delivery times were compared to evaluate treatment efficiency.
Results
The median CI was substantially better for the 3F-IMRT (0.65), TH-IMRT (0.64), and TH-3DCRT (0.63) plans, compared to the 2F-3DCRT plan (0.32). PTV HI was slightly better for TH-3DCRT and TH-IMRT (1.05) compared to 2F-3DCRT (1.06) and 3F-IMRT (1.09). TH-3DCRT, 3F-IMRT, and TH-IMRT showed an excellent carotid sparing capability compared to 2F-3DCRT (p < 0.05). For all plans, the maximum dose to the spinal cord was < 45 Gy. The median treatment planning times for 2F-3DCRT (5.85 minutes) and TH-3DCRT (7.10 minutes) were much lower than those for 3F-IMRT (45.48 minutes) and TH-IMRT (35.30 minutes). The delivery times for 2F-3DCRT (2.06 minutes) and 3F-IMRT (2.48 minutes) were slightly lower than those for TH-IMRT (2.90 minutes) and TH-3DCRT (2.86 minutes). Conclusion TH-3DCRT showed excellent carotid-sparing capability, while offering high efficiency and maintaining good PTV coverage.

Citations

Citations to this article as recorded by

Accelerated three‐dimensional conformal radiotherapy for early‐stage glottic cancer in reducing dose to the internal carotid artery and pharyngeal constrictor muscles
Kento Tomizawa, Atsushi Motegi, Hidekazu Oyoshi, Takeshi Fujisawa, Sadamoto Zenda, Yuzheng Zhou, Masaki Nakamura, Hidenari Hirata, Hidehiro Hojo, Shun‐ichiro Kageyama, Kouta Hirotaki, Kazuto Matsuura, Tetsuo Akimoto
Head & Neck.2024; 46(2): 239. CrossRef
Dosimetric comparison between carotid-sparing IMRT and 3DCRT in early glottic cancer patients treated with definitive radiation therapy
Harkirat Kaur, Niketa Thakur, Ramita Sharma, Meena Sudan, Neeraj Jain, Supreet Kaur, Priyanka Lehal
Journal of Cancer Research and Therapeutics.2024; 20(1): 327. CrossRef
AAPM Task Group Report 306: Quality control and assurance for tomotherapy: An update to Task Group Report 148
Quan Chen, Yi Rong, Jay W. Burmeister, Edward H. Chao, Nathan A. Corradini, David S. Followill, X. Allen Li, An Liu, X. Sharon Qi, Hairong Shi, Jennifer B. Smilowitz
Medical Physics.2023;[Epub] CrossRef
Application of error classification model using indices based on dose distribution for characteristics evaluation of multileaf collimator position errors
Heesoon Sheen, Han-Back Shin, Hojae Kim, Changhwan Kim, Jihun Kim, Jin Sung Kim, Chae-Seon Hong
Scientific Reports.2023;[Epub] CrossRef
Comparison of Carotid Artery Dose in Early-Stage Glottic Cancer Treated with 3D-Conformal, Helical-IMRT and VMAT
B Pires, D Rothwell, I Guimarães, J Sousa, R Magalhães, T Serra, L Khouri, P Alves
Forum of Clinical Oncology.2022; 13(3): 23. CrossRef
Preliminary Simulation Study of Carotid Artery and Pharyngeal Constrictor Muscle Sparing-Radiotherapy in Glottic Carcinoma
Yurday Ozdemir, Ibrahim Acibuci, Ugur Selek, Erkan Topkan
Technology in Cancer Research & Treatment.2020;[Epub] CrossRef
Dose-Volume Comparison of IMRT and PSPT Treatment Plans for Early-Stage Glottic Cancer
Takahiro Kato, Nobukazu Fuwa, Masao Murakami
International Journal of Particle Therapy.2020; 7(2): 42. CrossRef
Dosimetric Comparison of Four Different Techniques for Supraclavicular Irradiation in 3D-conformal Radiotherapy of Breast Cancer
Razzagh Abedi Firouzjah, Amin Banaei, Bagher Farhood, Mohsen Bakhshandeh
Health Physics.2019; 116(5): 631. CrossRef
Feasibility of hybrid TomoHelical- and TomoDirect-based volumetric gradient matching technique for total body irradiation
Chae-Seon Hong, Min-Joo Kim, Jihun Kim, Kyung Hwan Chang, Kwangwoo Park, Dong Wook Kim, Min Cheol Han, Hong In Yoon, Jin Sung Kim, Ho Lee
Radiation Oncology.2019;[Epub] CrossRef
Standardisation of Target Volume Delineation for Carotid-sparing Intensity-modulated Radiotherapy in Early Glottis Cancer
D.M. Gujral, M. Long, J.W.G. Roe, K.J. Harrington, C.M. Nutting
Clinical Oncology.2017; 29(1): 42. CrossRef
Carotid sparing intensity modulated radiotherapy on early glottic cancer: preliminary study
Hoon Sik Choi, Bae Kwon Jeong, Hojin Jeong, Jin Ho Song, Jin Pyeong Kim, Jung Je Park, Seung Hoon Woo, Ki Mun Kang
Radiation Oncology Journal.2016; 34(1): 26. CrossRef

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