BACKGROUND AND PURPOSE: To prospectively assess the feasibility and efficacy of an accelerated and hyperfractionated intensity- modulated radiation therapy (IMRT) schedule for intermediate T-stage oropharyngeal cancer. PATIENTS AND METHODS: Patients with T3 or unfavorable T2 oropharyngeal squamous cell carcinoma were eligible; a three-dose level simultaneous integrated boost IMRT strategy was used, delivering 78, 69, and 60 Gy to gross disease, high-risk and low-risk target areas, respectively, in 60 twice daily fractions over 6 weeks. No sequential/concomitant systemic treatment or up-front radical surgery was allowed. Median follow-up is 41.7 months (range: 3.5-80.8 months). RESULTS: 25 patients were treated from 11/2002 to 11/2005. 92% of the individual fractions were delivered as scheduled. Grade 3 mucosal and skin toxicity was 100% and 72%, respectively, none of which persisted beyond 12 weeks; a percutaneous endoscopic gastrostomy tube was temporarily placed in 60% of patients. The estimated locoregional progression-free, distant metastases-free, and overall survival rates at 3 years were 86.3% ± 7.4%, 76.4% ± 9.6%, and 70.0% ± 9.6%, respectively. At the same time interval, the actuarial prevalence of grade 3+ CTCAE v3.0 toxicity was 26.1%. CONCLUSION: While the routine clinical use of this exploratory schedule is discouraged, it may represent the basis for future developments.
BACKGROUND AND PURPOSE: To prospectively assess the feasibility and efficacy of an accelerated and hyperfractionated intensity- modulated radiation therapy (IMRT) schedule for intermediate T-stage oropharyngeal cancer. PATIENTS AND METHODS: Patients with T3 or unfavorable T2 oropharyngeal squamous cell carcinoma were eligible; a three-dose level simultaneous integrated boost IMRT strategy was used, delivering 78, 69, and 60 Gy to gross disease, high-risk and low-risk target areas, respectively, in 60 twice daily fractions over 6 weeks. No sequential/concomitant systemic treatment or up-front radical surgery was allowed. Median follow-up is 41.7 months (range: 3.5-80.8 months). RESULTS: 25 patients were treated from 11/2002 to 11/2005. 92% of the individual fractions were delivered as scheduled. Grade 3 mucosal and skin toxicity was 100% and 72%, respectively, none of which persisted beyond 12 weeks; a percutaneous endoscopic gastrostomy tube was temporarily placed in 60% of patients. The estimated locoregional progression-free, distant metastases-free, and overall survival rates at 3 years were 86.3% ± 7.4%, 76.4% ± 9.6%, and 70.0% ± 9.6%, respectively. At the same time interval, the actuarial prevalence of grade 3+ CTCAE v3.0 toxicity was 26.1%. CONCLUSION: While the routine clinical use of this exploratory schedule is discouraged, it may represent the basis for future developments.
Authors: Merav A Ben-David; Maximiliano Diamante; Jeffrey D Radawski; Karen A Vineberg; Cynthia Stroup; Carol-Anne Murdoch-Kinch; Samuel R Zwetchkenbaum; Avraham Eisbruch Journal: Int J Radiat Oncol Biol Phys Date: 2007-02-22 Impact factor: 7.038
Authors: Carole Fakhry; William H Westra; Sigui Li; Anthony Cmelak; John A Ridge; Harlan Pinto; Arlene Forastiere; Maura L Gillison Journal: J Natl Cancer Inst Date: 2008-02-12 Impact factor: 13.506
Authors: Barbara A Jereczek-Fossa; Elena Rondi; Andrzej Zarowski; Alberto D'Onofrio; Daniela Alterio; Mario Ciocca; Livia Corinna Bianchi; Marco Krengli; Luca Calabrese; Mohssen Ansarin; Gioacchino Giugliano; Roberto Orecchia Journal: Strahlenther Onkol Date: 2011-05-16 Impact factor: 3.621
Authors: V E M Mul; J M A de Jong; L H P Murrer; P L A van den Ende; R M A Houben; M Lacko; P Lambin; B G Baumert Journal: Strahlenther Onkol Date: 2011-12-23 Impact factor: 3.621
Authors: David N Teguh; Peter C Levendag; Wendimagegn Ghidey; Kees van Montfort; Stefan L S Kwa Journal: Dysphagia Date: 2013-01-26 Impact factor: 3.438