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Intensity-modulated radiotherapy reduces radiation-induced morbidity and improves health-related quality of life: results of a nonrandomized prospective study using a standardized follow-up program.
Int J Radiat Oncol Biol Phys. 2009 May 01; 74(1):1-8.IJ

Abstract

PURPOSE

The purpose of this study was to compare intensity-modulated radiation therapy (IMRT) and three-dimensional conventional radiotherapy (3D-CRT) with regard to patient-rated xerostomia, Radiation Therapy Oncology Group (RTOG) acute and late xerostomia and health-related quality of life (HRQoL) among patients with head and neck squamous cell carcinoma (HNSCC).

METHODS AND MATERIALS

Included were 241 patients with HNSCC treated with bilateral irradiation +/- chemotherapy. Since 2000, all patients treated with HNSCC were included in a program, which prospectively assessed acute and late morbidity according to the RTOG and HRQoL on a routine basis at regular intervals. Before October 2004, all patients were treated with 3D-CRT (N = 150). After clinical implementation in October 2004, 91 patients received IMRT. In this study, the differences regarding RTOG toxicity, xerostomia, and other items of HRQoL were analyzed.

RESULTS

The use of IMRT resulted in a significant reduction of the mean dose of the parotid glands (27 Gy vs. 43 Gy (p < 0.001). During radiation, Grade 2 RTOG xerostomia was significantly less with IMRT than with 3D-CRT. At 6 months, the prevalence of patient-rated moderate to severe xerostomia and Grade 2 or higher RTOG xerostomia was significantly lower after IMRT versus 3D-CRT. Treatment with IMRT also had a positive effect on several general and head and neck cancer-specific HRQoL dimensions.

CONCLUSIONS

IMRT results in a significant reduction of patient- and observer-rated xerostomia, as well as other head and neck symptoms, compared with standard 3D-CRT. These differences translate into a significant improvement of the more general dimensions of HRQoL.

Authors+Show Affiliations

Department of Radiation Oncology, VU University Medical Center, Amsterdam, the Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

19111400

Citation

Vergeer, Marije R., et al. "Intensity-modulated Radiotherapy Reduces Radiation-induced Morbidity and Improves Health-related Quality of Life: Results of a Nonrandomized Prospective Study Using a Standardized Follow-up Program." International Journal of Radiation Oncology, Biology, Physics, vol. 74, no. 1, 2009, pp. 1-8.
Vergeer MR, Doornaert PA, Rietveld DH, et al. Intensity-modulated radiotherapy reduces radiation-induced morbidity and improves health-related quality of life: results of a nonrandomized prospective study using a standardized follow-up program. Int J Radiat Oncol Biol Phys. 2009;74(1):1-8.
Vergeer, M. R., Doornaert, P. A., Rietveld, D. H., Leemans, C. R., Slotman, B. J., & Langendijk, J. A. (2009). Intensity-modulated radiotherapy reduces radiation-induced morbidity and improves health-related quality of life: results of a nonrandomized prospective study using a standardized follow-up program. International Journal of Radiation Oncology, Biology, Physics, 74(1), 1-8. https://doi.org/10.1016/j.ijrobp.2008.07.059
Vergeer MR, et al. Intensity-modulated Radiotherapy Reduces Radiation-induced Morbidity and Improves Health-related Quality of Life: Results of a Nonrandomized Prospective Study Using a Standardized Follow-up Program. Int J Radiat Oncol Biol Phys. 2009 May 1;74(1):1-8. PubMed PMID: 19111400.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intensity-modulated radiotherapy reduces radiation-induced morbidity and improves health-related quality of life: results of a nonrandomized prospective study using a standardized follow-up program. AU - Vergeer,Marije R, AU - Doornaert,Patricia A H, AU - Rietveld,Derek H F, AU - Leemans,C René, AU - Slotman,Ben J, AU - Langendijk,Johannes A, Y1 - 2008/12/26/ PY - 2008/03/17/received PY - 2008/06/13/revised PY - 2008/07/28/accepted PY - 2008/12/30/entrez PY - 2008/12/30/pubmed PY - 2009/4/22/medline SP - 1 EP - 8 JF - International journal of radiation oncology, biology, physics JO - Int J Radiat Oncol Biol Phys VL - 74 IS - 1 N2 - PURPOSE: The purpose of this study was to compare intensity-modulated radiation therapy (IMRT) and three-dimensional conventional radiotherapy (3D-CRT) with regard to patient-rated xerostomia, Radiation Therapy Oncology Group (RTOG) acute and late xerostomia and health-related quality of life (HRQoL) among patients with head and neck squamous cell carcinoma (HNSCC). METHODS AND MATERIALS: Included were 241 patients with HNSCC treated with bilateral irradiation +/- chemotherapy. Since 2000, all patients treated with HNSCC were included in a program, which prospectively assessed acute and late morbidity according to the RTOG and HRQoL on a routine basis at regular intervals. Before October 2004, all patients were treated with 3D-CRT (N = 150). After clinical implementation in October 2004, 91 patients received IMRT. In this study, the differences regarding RTOG toxicity, xerostomia, and other items of HRQoL were analyzed. RESULTS: The use of IMRT resulted in a significant reduction of the mean dose of the parotid glands (27 Gy vs. 43 Gy (p < 0.001). During radiation, Grade 2 RTOG xerostomia was significantly less with IMRT than with 3D-CRT. At 6 months, the prevalence of patient-rated moderate to severe xerostomia and Grade 2 or higher RTOG xerostomia was significantly lower after IMRT versus 3D-CRT. Treatment with IMRT also had a positive effect on several general and head and neck cancer-specific HRQoL dimensions. CONCLUSIONS: IMRT results in a significant reduction of patient- and observer-rated xerostomia, as well as other head and neck symptoms, compared with standard 3D-CRT. These differences translate into a significant improvement of the more general dimensions of HRQoL. SN - 1879-355X UR - https://www.unboundmedicine.com/medline/citation/19111400/Intensity_modulated_radiotherapy_reduces_radiation_induced_morbidity_and_improves_health_related_quality_of_life:_results_of_a_nonrandomized_prospective_study_using_a_standardized_follow_up_program_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0360-3016(08)03311-7 DB - PRIME DP - Unbound Medicine ER -