PMC4204450_01
Representative cumulative dose distribution of IMRT followed by SBRT plan of patient no. 6 of Table 1 who was treated definitively to gross disease with concurrent cetuximab for a Stage T4bN2b squamous cell carcinoma of the parotid. (A,B) Representative axial views at the base of skull and the parotid gland. (C,D) Representative coronal and sagittal views. The outer brown isodose line represents the 70 Gy line, followed by the 75 Gy line in green, and 80 Gy in yellow. The innermost dark brown shaded area represents the planned treatment volume (PTV). The dark green contoured volume represents the brainstem.
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F1
(A) Cumulative dose volume histograms (DVHs) of PTV and critical structures showing from left to right, PTV (red), brainstem (green), optic chiasm (yellow), and left optic nerve (blue). (B) SBRT DVHs for the corresponding structures shown in (A). According to the TG 101 SBRT tolerance for the brainstem is a maximum point dose of 25 Gy in five fractions and <5 cc of the brainstem receiving 6.6 Gy/fraction. The tolerance for the optic pathways is a maximum point dose of 25 Gy in five fractions.
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F2
At a median follow-up of 29 months (range 12-120 months) for all patients and 43 months for surviving patients (range 12-120 months), actuarial LRC, distant control (DC), PFS, and OS were 88, 81, 68, and 79%, respectively (Table 2, Figure 2).
Survival outcomes at a median follow-up of 29 months for all patients and 37 months for surviving patients. (A) Locoregional control. (B) Distant control. (C) Progression-free survival. (D) Overall survival.
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F3
A summary of survival outcomes is shown in Table 2 and Figure 3.