Intensity-modulated radiotherapy in the treatment of oropharyngeal cancer: an update of the Memorial Sloan-Kettering Cancer Center experience.
Int J Radiat Oncol Biol Phys. 2012 Jan 01; 82(1):291-8.IJ

Abstract

PURPOSE

To update the Memorial Sloan-Kettering Cancer Center's experience with intensity-modulated radiotherapy (IMRT) in the treatment of oropharyngeal cancer (OPC).

METHODS AND MATERIALS

Between September 1998 and April 2009, 442 patients with histologically confirmed OPC underwent IMRT at our center. There were 379 men and 63 women with a median age of 57 years (range, 27-91). The disease was Stage I in 2%, Stage II in 4%, Stage III in 21%, and Stage IV in 73% of patients. The primary tumor subsite was tonsil in 50%, base of tongue in 46%, pharyngeal wall in 3%, and soft palate in 2%. The median prescription dose to the planning target volume of the gross tumor was 70 Gy for definitive (n = 412) cases and 66 Gy for postoperative cases (n = 30). A total 404 patients (91%) received chemotherapy, including 389 (88%) who received concurrent chemotherapy, the majority of which was platinum-based.

RESULTS

Median follow-up among surviving patients was 36.8 months (range, 3-135). The 3-year cumulative incidence of local failure, regional failure, and distant metastasis was 5.4%, 5.6%, and 12.5%, respectively. The 3-year OS rate was 84.9%. The incidence of late dysphagia and late xerostomia ≥Grade 2 was 11% and 29%, respectively.

CONCLUSIONS

Our results confirm the feasibility of IMRT in achieving excellent locoregional control and low rates of xerostomia. According to our knowledge, this study is the largest report of patients treated with IMRT for OPC.

Links

Publisher Full Text
Aggregator Full Text

Authors+Show Affiliations

Setton J
Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA.
Caria N
No affiliation info available
Romanyshyn J
No affiliation info available
Koutcher L
No affiliation info available
Wolden SL
No affiliation info available
Zelefsky MJ
No affiliation info available
Rowan N
No affiliation info available
Sherman EJ
No affiliation info available
Fury MG
No affiliation info available
Pfister DG
No affiliation info available
Wong RJ
No affiliation info available
Shah JP
No affiliation info available
Kraus DH
No affiliation info available
Shi W
No affiliation info available
Zhang Z
No affiliation info available
Schupak KD
No affiliation info available
Gelblum DY
No affiliation info available
Rao SD
No affiliation info available
Lee NY
No affiliation info available

MeSH

AdultAgedAged, 80 and overAnalysis of VarianceAntineoplastic Combined Chemotherapy ProtocolsCancer Care FacilitiesDeglutition DisordersFemaleFollow-Up StudiesHumansIncidenceMaleMiddle AgedNeoplasm StagingNew York CityOropharyngeal NeoplasmsPalatal NeoplasmsPalate, SoftPharyngeal NeoplasmsRadiotherapy DosageRadiotherapy, Intensity-ModulatedTongue NeoplasmsTonsillar NeoplasmsTreatment FailureXerostomia

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21167652