PURPOSE: To determine the outcome of patients treated with intensity-modulated radiotherapy (IMRT) for head and neck cancer. METHODS AND MATERIALS: We reviewed the charts of 100 consecutive patients treated with IMRT for squamous cell carcinoma of the oropharynx (64%), nasopharynx (16%), hypopharynx (14%), and larynx (6%). Most patients were treated with a concomitant boost schedule to 72 Gy. Of the 100 patients, 54 (54%) received adjuvant chemotherapy, mostly concurrent cisplatin. The dosimetry plans for patients with either locoregional failure or Grade 4-5 complications were reviewed and fused over the computed tomography images corresponding with the location of the event. Marginal failures were defined as those that occurred at a region of high-dose falloff, where conventional fields would have provided better coverage. RESULTS: The median follow-up of living patients was 3.1 years (range, 1-5.2 years). The 3-year rate of local control, locoregional control, freedom from relapse, cause-specific survival, and overall survival for all patients was 89%, 87%, 72%, 78%, and 71%, respectively. The 3-year rate of freedom from relapse, cause-specific survival, and overall survival for the 64 oropharynx patients was 86%, 92%, and 84%, respectively. Of the 10 local failures, 2 occurred at the margin of the high-dose planning target volume. Both regional failures occurred within the planning target volume. No locoregional failures occurred outside the planning target volume. Of the 100 patients, 8 and 5 had Grade 4 and 5 complications from treatment, respectively. All patients with Grade 5 complications had received adjuvant chemotherapy. No attempt was made to discriminate between the complications from IMRT and other aspects of the patients' treatment. CONCLUSION: Intensity-modulated radiotherapy did not compromise the outcome compared with what we have achieved with conventional techniques. The 2 cases of recurrence in the high-dose gradient region highlight the potential hazard of approaches that involve highly conformal dose distributions.
PURPOSE: To determine the outcome of patients treated with intensity-modulated radiotherapy (IMRT) for head and neck cancer. METHODS AND MATERIALS: We reviewed the charts of 100 consecutive patients treated with IMRT for squamous cell carcinoma of the oropharynx (64%), nasopharynx (16%), hypopharynx (14%), and larynx (6%). Most patients were treated with a concomitant boost schedule to 72 Gy. Of the 100 patients, 54 (54%) received adjuvant chemotherapy, mostly concurrent cisplatin. The dosimetry plans for patients with either locoregional failure or Grade 4-5 complications were reviewed and fused over the computed tomography images corresponding with the location of the event. Marginal failures were defined as those that occurred at a region of high-dose falloff, where conventional fields would have provided better coverage. RESULTS: The median follow-up of living patients was 3.1 years (range, 1-5.2 years). The 3-year rate of local control, locoregional control, freedom from relapse, cause-specific survival, and overall survival for all patients was 89%, 87%, 72%, 78%, and 71%, respectively. The 3-year rate of freedom from relapse, cause-specific survival, and overall survival for the 64 oropharynx patients was 86%, 92%, and 84%, respectively. Of the 10 local failures, 2 occurred at the margin of the high-dose planning target volume. Both regional failures occurred within the planning target volume. No locoregional failures occurred outside the planning target volume. Of the 100 patients, 8 and 5 had Grade 4 and 5 complications from treatment, respectively. All patients with Grade 5 complications had received adjuvant chemotherapy. No attempt was made to discriminate between the complications from IMRT and other aspects of the patients' treatment. CONCLUSION: Intensity-modulated radiotherapy did not compromise the outcome compared with what we have achieved with conventional techniques. The 2 cases of recurrence in the high-dose gradient region highlight the potential hazard of approaches that involve highly conformal dose distributions.
Authors: Abdallah S R Mohamed; Carlos E Cardenas; Adam S Garden; Musaddiq J Awan; Crosby D Rock; Sarah A Westergaard; G Brandon Gunn; Abdelaziz M Belal; Ahmed G El-Gowily; Stephen Y Lai; David I Rosenthal; Clifton D Fuller; Michalis Aristophanous Journal: Radiother Oncol Date: 2017-07-31 Impact factor: 6.280
Authors: A K Due; I R Vogelius; M C Aznar; S M Bentzen; A K Berthelsen; S S Korreman; C A Kristensen; L Specht Journal: Strahlenther Onkol Date: 2012-05-13 Impact factor: 3.621
Authors: Aruna Turaka; Tianyu Li; Nicos Nicolaou; Miriam N Lango; Barbara Burtness; Eric M Horwitz; John A Ridge; Steven J Feigenberg Journal: Int J Radiat Oncol Biol Phys Date: 2010-04-10 Impact factor: 7.038
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: Paul B Romesser; Muhammad M Qureshi; Rathan M Subramaniam; Osamu Sakai; Scharukh Jalisi; Minh T Truong Journal: Am J Clin Oncol Date: 2014-04 Impact factor: 2.339