Tags

Type your tag names separated by a space and hit enter

A comparison of intensity-modulated radiation therapy and concomitant boost radiotherapy in the setting of concurrent chemotherapy for locally advanced oropharyngeal carcinoma.
Int J Radiat Oncol Biol Phys. 2006 Nov 15; 66(4):966-74.IJ

Abstract

PURPOSE

The aim of this study was to compare toxicity/efficacy of conventional radiotherapy using delayed accelerated concomitant boost radiotherapy (CBRT) vs. intensity-modulated radiotherapy (IMRT) in the setting of concurrent chemotherapy (CT) for locally advanced oropharyngeal carcinoma.

METHODS AND MATERIALS

Between September 1998 and June 2004, a total of 293 consecutive patients were treated at our institution for cancer of the oropharynx. Of these, 112 had Stage III/IV disease and squamous cell histology. In all, 41 were treated with IMRT/CT and 71 were treated with CBRT/CT, both to a median dose of 70 Gy. Most common CT was a planned two cycles given every 3 to 4 weeks of cisplatin, 100 mg/m2 i.v., but an additional cycle was given to IMRT patients when possible. Both groups were well-matched for all prognostic factors.

RESULTS

Median follow-up was 46 months (range, 3-93 months) for the CBRT patients and 31 months (range, 20-64 months) for the IMRT group. Three-year actuarial local-progression-free, regional-progression-free, locoregional progression-free, distant-metastases-free, disease-free, and overall survival rates were 85% vs. 95% (p = 0.17), 95% vs. 94% (p = 0.90), 82% vs. 92% (p = 0.18), 85% vs. 86% (p = 0.78), 76% vs. 82% (p = 0.57), and 81% vs. 91% (p = 0.10) for CBRT and IMRT patients, respectively. Three patients died of treatment-related toxicity in the CBRT group vs. none undergoing IMRT. At 2 years, 4% IMRT patients vs. 21% CBRT patients were dependent on percutaneous endoscopic gastrostomy (p = 0.02). Among those who had > or =20 months follow-up, there was a significant difference in Grade > or =2 xerostomia as defined by the criteria of the Radiation Therapy and Oncology Group, 67% vs. 12% (p = 0.02), in the CBRT vs. IMRT arm.

CONCLUSION

In the setting of CT for locally advanced oropharyngeal carcinoma, IMRT results in lower toxicity and similar treatment outcomes when compared with CBRT.

Authors+Show Affiliations

Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA. leen2@mskcc.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Controlled Clinical Trial
Journal Article

Language

eng

PubMed ID

17145527

Citation

Lee, Nancy Y., et al. "A Comparison of Intensity-modulated Radiation Therapy and Concomitant Boost Radiotherapy in the Setting of Concurrent Chemotherapy for Locally Advanced Oropharyngeal Carcinoma." International Journal of Radiation Oncology, Biology, Physics, vol. 66, no. 4, 2006, pp. 966-74.
Lee NY, de Arruda FF, Puri DR, et al. A comparison of intensity-modulated radiation therapy and concomitant boost radiotherapy in the setting of concurrent chemotherapy for locally advanced oropharyngeal carcinoma. Int J Radiat Oncol Biol Phys. 2006;66(4):966-74.
Lee, N. Y., de Arruda, F. F., Puri, D. R., Wolden, S. L., Narayana, A., Mechalakos, J., Venkatraman, E. S., Kraus, D., Shaha, A., Shah, J. P., Pfister, D. G., & Zelefsky, M. J. (2006). A comparison of intensity-modulated radiation therapy and concomitant boost radiotherapy in the setting of concurrent chemotherapy for locally advanced oropharyngeal carcinoma. International Journal of Radiation Oncology, Biology, Physics, 66(4), 966-74.
Lee NY, et al. A Comparison of Intensity-modulated Radiation Therapy and Concomitant Boost Radiotherapy in the Setting of Concurrent Chemotherapy for Locally Advanced Oropharyngeal Carcinoma. Int J Radiat Oncol Biol Phys. 2006 Nov 15;66(4):966-74. PubMed PMID: 17145527.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A comparison of intensity-modulated radiation therapy and concomitant boost radiotherapy in the setting of concurrent chemotherapy for locally advanced oropharyngeal carcinoma. AU - Lee,Nancy Y, AU - de Arruda,Fernando F, AU - Puri,Dev R, AU - Wolden,Suzanne L, AU - Narayana,Ashwatha, AU - Mechalakos,James, AU - Venkatraman,Ennapadam S, AU - Kraus,Dennis, AU - Shaha,Ashok, AU - Shah,Jatin P, AU - Pfister,David G, AU - Zelefsky,Michael J, PY - 2006/05/01/received PY - 2006/06/03/revised PY - 2006/06/06/accepted PY - 2006/12/6/pubmed PY - 2007/11/7/medline PY - 2006/12/6/entrez SP - 966 EP - 74 JF - International journal of radiation oncology, biology, physics JO - Int J Radiat Oncol Biol Phys VL - 66 IS - 4 N2 - PURPOSE: The aim of this study was to compare toxicity/efficacy of conventional radiotherapy using delayed accelerated concomitant boost radiotherapy (CBRT) vs. intensity-modulated radiotherapy (IMRT) in the setting of concurrent chemotherapy (CT) for locally advanced oropharyngeal carcinoma. METHODS AND MATERIALS: Between September 1998 and June 2004, a total of 293 consecutive patients were treated at our institution for cancer of the oropharynx. Of these, 112 had Stage III/IV disease and squamous cell histology. In all, 41 were treated with IMRT/CT and 71 were treated with CBRT/CT, both to a median dose of 70 Gy. Most common CT was a planned two cycles given every 3 to 4 weeks of cisplatin, 100 mg/m2 i.v., but an additional cycle was given to IMRT patients when possible. Both groups were well-matched for all prognostic factors. RESULTS: Median follow-up was 46 months (range, 3-93 months) for the CBRT patients and 31 months (range, 20-64 months) for the IMRT group. Three-year actuarial local-progression-free, regional-progression-free, locoregional progression-free, distant-metastases-free, disease-free, and overall survival rates were 85% vs. 95% (p = 0.17), 95% vs. 94% (p = 0.90), 82% vs. 92% (p = 0.18), 85% vs. 86% (p = 0.78), 76% vs. 82% (p = 0.57), and 81% vs. 91% (p = 0.10) for CBRT and IMRT patients, respectively. Three patients died of treatment-related toxicity in the CBRT group vs. none undergoing IMRT. At 2 years, 4% IMRT patients vs. 21% CBRT patients were dependent on percutaneous endoscopic gastrostomy (p = 0.02). Among those who had > or =20 months follow-up, there was a significant difference in Grade > or =2 xerostomia as defined by the criteria of the Radiation Therapy and Oncology Group, 67% vs. 12% (p = 0.02), in the CBRT vs. IMRT arm. CONCLUSION: In the setting of CT for locally advanced oropharyngeal carcinoma, IMRT results in lower toxicity and similar treatment outcomes when compared with CBRT. SN - 1879-355X UR - https://www.unboundmedicine.com/medline/citation/17145527/A_comparison_of_intensity_modulated_radiation_therapy_and_concomitant_boost_radiotherapy_in_the_setting_of_concurrent_chemotherapy_for_locally_advanced_oropharyngeal_carcinoma_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0360-3016(06)01127-8 DB - PRIME DP - Unbound Medicine ER -