OBJECTIVE: Review the University of Iowa experience with intensity modulated radiation treatment (IMRT) in oropharyngeal squamous cell carcinoma. METHODS: From January 2000 to July 2004, 66 patients with oropharyngeal cancer were treated with IMRT, 62 with definitive IMRT and 4 postoperative IMRT. Three target volumes (CTV1, CTV2, and CTV3) were defined. The prescribed doses to CTV1, CTV2, and CTV3 were 70 to 74 Gy, 60 Gy, and 54 Gy, respectively, for definitive IMRT, and 60 to 66 Gy, 60 Gy, and 54 Gy, respectively, for postoperative IMRT. RESULTS: Median follow-up was 27.3 months and all living patients had a follow-up of at least 11.5 months. The 3-year estimate of locoregional progression free survival was 98.8%. However, there is a high incidence of distant metastasis with a 3-year estimate of distant metastasis-free survival of 80.4%. In addition, there is a high incidence of second primary tumor. The 3-year overall survival and 3-year disease-free survival were 78.1% and 64.4%, respectively. Treatment was well tolerated with 1 death resulting from treatment toxicity. CONCLUSIONS: IMRT offers an excellent locoregional control for oropharyngeal cancer patients. Failure patterns have changed with an increased portion of patients who failed distantly, either with metastasis or second primary tumor. Therefore, survival for these patients is still poor. Future research should focus on identifying patients at high risk of distant diseases and developing effective systemic treatment and prevention for distant diseases.
OBJECTIVE: Review the University of Iowa experience with intensity modulated radiation treatment (IMRT) in oropharyngeal squamous cell carcinoma. METHODS: From January 2000 to July 2004, 66 patients with oropharyngeal cancer were treated with IMRT, 62 with definitive IMRT and 4 postoperative IMRT. Three target volumes (CTV1, CTV2, and CTV3) were defined. The prescribed doses to CTV1, CTV2, and CTV3 were 70 to 74 Gy, 60 Gy, and 54 Gy, respectively, for definitive IMRT, and 60 to 66 Gy, 60 Gy, and 54 Gy, respectively, for postoperative IMRT. RESULTS: Median follow-up was 27.3 months and all living patients had a follow-up of at least 11.5 months. The 3-year estimate of locoregional progression free survival was 98.8%. However, there is a high incidence of distant metastasis with a 3-year estimate of distant metastasis-free survival of 80.4%. In addition, there is a high incidence of second primary tumor. The 3-year overall survival and 3-year disease-free survival were 78.1% and 64.4%, respectively. Treatment was well tolerated with 1 death resulting from treatment toxicity. CONCLUSIONS: IMRT offers an excellent locoregional control for oropharyngeal cancerpatients. Failure patterns have changed with an increased portion of patients who failed distantly, either with metastasis or second primary tumor. Therefore, survival for these patients is still poor. Future research should focus on identifying patients at high risk of distant diseases and developing effective systemic treatment and prevention for distant diseases.
Authors: Felix Y Feng; Hyungjin M Kim; Teresa H Lyden; Marc J Haxer; Francis P Worden; Mary Feng; Jeffrey S Moyer; Mark E Prince; Thomas E Carey; Gregory T Wolf; Carol R Bradford; Douglas B Chepeha; Avraham Eisbruch Journal: J Clin Oncol Date: 2010-04-26 Impact factor: 44.544
Authors: Missak Haigentz; Carl E Silver; June Corry; Eric M Genden; Robert P Takes; Alessandra Rinaldo; Alfio Ferlito Journal: Eur Arch Otorhinolaryngol Date: 2009-12 Impact factor: 2.503
Authors: Avraham Eisbruch; Jonathan Harris; Adam S Garden; Clifford K S Chao; William Straube; Paul M Harari; Giuseppe Sanguineti; Christopher U Jones; Walter R Bosch; K Kian Ang Journal: Int J Radiat Oncol Biol Phys Date: 2009-06-18 Impact factor: 7.038
Authors: Didem C Oksuz; Robin J Prestwich; Brendan Carey; Stuart Wilson; Mustafa S Senocak; Ananya Choudhury; Karen Dyker; Catherine Coyle; Mehmet Sen Journal: Radiat Oncol Date: 2011-05-24 Impact factor: 3.481