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Intensity-modulated radiation therapy for oropharyngeal carcinoma: impact of tumor volume.
Int J Radiat Oncol Biol Phys. 2004 May 01; 59(1):43-50.IJ

Abstract

PURPOSE

To assess the therapeutic outcomes in oropharyngeal cancer patients treated with intensity-modulated radiotherapy (IMRT) and analyze the impact of primary gross tumor volume (GTV) and nodal GTV (nGTV) on survival and locoregional control rates.

METHODS AND MATERIALS

Between February 1997 and September 2001, 74 patients with squamous cell carcinoma of the oropharynx were treated with IMRT. Thirty-one patients received definitive IMRT; 17 also received platinum-based chemotherapy. Forty-three patients received combined surgery and postoperative IMRT. The median follow-up for all patients was 33 months (range, 9-60 months). Fifty-two patients (70.3%) had Stage IV disease, 17 patients (23%) had Stage III, 3 patients (4.1%) had Stage II, and 2 patients (2.7%) had Stage I tumors. The mean prescription dose was 70 and 66 Gy, respectively, for the definitive and postoperative cohorts. The daily fraction dose was either 1.9 or 2 Gy, five times weekly. The GTV and/or nGTV were determined and derived using the Computational Environment for Radiotherapy Research, a free software package developed at Washington University. The mean GTV was 30.5 +/- 22.3 cm(3), and the mean nGTV was 23.2 +/- 20.6 cm(3).

RESULTS

Ten locoregional failures were observed. Six patients died of disease and three died of concurrent disease. Distant metastasis developed in 6 patients. The 4-year estimate of overall survival was 87%, and the 4-year estimate of disease-free survival was 81% (66% in the definitive vs. 92% in the postoperative RT group). The 4-year estimate of locoregional control was 87% (78% in the definitive vs. 95% in the postoperative RT group); the 4-year estimate of distant metastasis-free survival was 90% (84% in the definitive vs. 94% in the postoperative group). Multivariate analysis showed that GTV and nGTV were independent risk factors determining locoregional control and disease-free survival for definitive oropharyngeal IMRT patients. The worst late toxicities documented were as follows: 32 patients with Grade 1 and 9 with Grade 2 xerostomia; 2 with Grade 1 and 1 with Grade 2 skin toxicity; 3 with Grade 1 late mucositis; and 3 with Grade 1 trismus. Seventeen patients required gastrostomy tube placement.

CONCLUSION

IMRT is an effective treatment modality for locally advanced oropharyngeal carcinoma. The GTV and nGTV are the most important factors predictive of therapeutic outcome.

Authors+Show Affiliations

Department of Radiation Oncology, The University of Texas, M. D. Anderson Cancer Center, Houston, TX 77030, USA. cchao@mdanderson.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15093897

Citation

Chao, K S Clifford, et al. "Intensity-modulated Radiation Therapy for Oropharyngeal Carcinoma: Impact of Tumor Volume." International Journal of Radiation Oncology, Biology, Physics, vol. 59, no. 1, 2004, pp. 43-50.
Chao KS, Ozyigit G, Blanco AI, et al. Intensity-modulated radiation therapy for oropharyngeal carcinoma: impact of tumor volume. Int J Radiat Oncol Biol Phys. 2004;59(1):43-50.
Chao, K. S., Ozyigit, G., Blanco, A. I., Thorstad, W. L., Deasy, J. O., Haughey, B. H., Spector, G. J., & Sessions, D. G. (2004). Intensity-modulated radiation therapy for oropharyngeal carcinoma: impact of tumor volume. International Journal of Radiation Oncology, Biology, Physics, 59(1), 43-50.
Chao KS, et al. Intensity-modulated Radiation Therapy for Oropharyngeal Carcinoma: Impact of Tumor Volume. Int J Radiat Oncol Biol Phys. 2004 May 1;59(1):43-50. PubMed PMID: 15093897.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intensity-modulated radiation therapy for oropharyngeal carcinoma: impact of tumor volume. AU - Chao,K S Clifford, AU - Ozyigit,Gokhan, AU - Blanco,Angel I, AU - Thorstad,Wade L, AU - Deasy,Joseph O, AU - Haughey,Bruce H, AU - Spector,Gershon J, AU - Sessions,Donald G, PY - 2003/04/17/received PY - 2003/07/21/revised PY - 2003/08/04/accepted PY - 2004/4/20/pubmed PY - 2004/5/25/medline PY - 2004/4/20/entrez SP - 43 EP - 50 JF - International journal of radiation oncology, biology, physics JO - Int J Radiat Oncol Biol Phys VL - 59 IS - 1 N2 - PURPOSE: To assess the therapeutic outcomes in oropharyngeal cancer patients treated with intensity-modulated radiotherapy (IMRT) and analyze the impact of primary gross tumor volume (GTV) and nodal GTV (nGTV) on survival and locoregional control rates. METHODS AND MATERIALS: Between February 1997 and September 2001, 74 patients with squamous cell carcinoma of the oropharynx were treated with IMRT. Thirty-one patients received definitive IMRT; 17 also received platinum-based chemotherapy. Forty-three patients received combined surgery and postoperative IMRT. The median follow-up for all patients was 33 months (range, 9-60 months). Fifty-two patients (70.3%) had Stage IV disease, 17 patients (23%) had Stage III, 3 patients (4.1%) had Stage II, and 2 patients (2.7%) had Stage I tumors. The mean prescription dose was 70 and 66 Gy, respectively, for the definitive and postoperative cohorts. The daily fraction dose was either 1.9 or 2 Gy, five times weekly. The GTV and/or nGTV were determined and derived using the Computational Environment for Radiotherapy Research, a free software package developed at Washington University. The mean GTV was 30.5 +/- 22.3 cm(3), and the mean nGTV was 23.2 +/- 20.6 cm(3). RESULTS: Ten locoregional failures were observed. Six patients died of disease and three died of concurrent disease. Distant metastasis developed in 6 patients. The 4-year estimate of overall survival was 87%, and the 4-year estimate of disease-free survival was 81% (66% in the definitive vs. 92% in the postoperative RT group). The 4-year estimate of locoregional control was 87% (78% in the definitive vs. 95% in the postoperative RT group); the 4-year estimate of distant metastasis-free survival was 90% (84% in the definitive vs. 94% in the postoperative group). Multivariate analysis showed that GTV and nGTV were independent risk factors determining locoregional control and disease-free survival for definitive oropharyngeal IMRT patients. The worst late toxicities documented were as follows: 32 patients with Grade 1 and 9 with Grade 2 xerostomia; 2 with Grade 1 and 1 with Grade 2 skin toxicity; 3 with Grade 1 late mucositis; and 3 with Grade 1 trismus. Seventeen patients required gastrostomy tube placement. CONCLUSION: IMRT is an effective treatment modality for locally advanced oropharyngeal carcinoma. The GTV and nGTV are the most important factors predictive of therapeutic outcome. SN - 0360-3016 UR - https://www.unboundmedicine.com/medline/citation/15093897/Intensity_modulated_radiation_therapy_for_oropharyngeal_carcinoma:_impact_of_tumor_volume_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0360301603017474 DB - PRIME DP - Unbound Medicine ER -