OBJECTIVES/HYPOTHESIS: To investigate the impact of treatment modality and radiation technique on oncologic outcomes and toxicity of patients with locally advanced oropharyngeal cancer (OPC). STUDY DESIGN: Retrospective analysis of outcomes and toxicity. METHODS: Between 2000 and 2011, 204 consecutive patients with locally advanced OPC were treated with definitive (chemo)radiotherapy using 3-dimensional conformal (3DCRT) or intensity-modulated radiotherapy (IMRT). Endpoints were local control (LC), regional control (RC), disease-free survival (DFS), cause-specific survival (CSS), and overall survival (OS), and toxicity. RESULTS: After a median follow-up of 44 months (range 4-134), the 5-year Kaplan-Meier estimates of LC, RC, DFS, CSS, and OS were 78%, 92%, 60%, 64%, and 48%, respectively. Grade 3 mucositis and dysphagia (feeding-tube dependency) were reported in 75% and 65%, respectively. The overall incidence of grade ≥ 2 and grade 3 late toxicities were 44% and 16%, respectively. Dysphagia and xerostomia were the most frequently reported late toxicity. Chemotherapy was significantly predictive for improved outcomes and increased toxicity. IMRT was significantly correlated with reduced toxicity. CONCLUSIONS: Compared to radiation alone, chemoradiotherapy significantly improved oncologic outcomes, but with significantly increased toxicity. Compared to 3DCRT, the introduction of IMRT resulted in a significant reduction of acute and late toxicity with slightly better, or at least comparable, outcomes. Despite the improvements achieved by the implementation of chemo-IMRT, different new strategies to further improve outcome and reduce toxicity need to be thoroughly investigated in prospective, preferably, randomized trials.
OBJECTIVES/HYPOTHESIS: To investigate the impact of treatment modality and radiation technique on oncologic outcomes and toxicity of patients with locally advanced oropharyngeal cancer (OPC). STUDY DESIGN: Retrospective analysis of outcomes and toxicity. METHODS: Between 2000 and 2011, 204 consecutive patients with locally advanced OPC were treated with definitive (chemo)radiotherapy using 3-dimensional conformal (3DCRT) or intensity-modulated radiotherapy (IMRT). Endpoints were local control (LC), regional control (RC), disease-free survival (DFS), cause-specific survival (CSS), and overall survival (OS), and toxicity. RESULTS: After a median follow-up of 44 months (range 4-134), the 5-year Kaplan-Meier estimates of LC, RC, DFS, CSS, and OS were 78%, 92%, 60%, 64%, and 48%, respectively. Grade 3 mucositis and dysphagia (feeding-tube dependency) were reported in 75% and 65%, respectively. The overall incidence of grade ≥ 2 and grade 3 late toxicities were 44% and 16%, respectively. Dysphagia and xerostomia were the most frequently reported late toxicity. Chemotherapy was significantly predictive for improved outcomes and increased toxicity. IMRT was significantly correlated with reduced toxicity. CONCLUSIONS: Compared to radiation alone, chemoradiotherapy significantly improved oncologic outcomes, but with significantly increased toxicity. Compared to 3DCRT, the introduction of IMRT resulted in a significant reduction of acute and late toxicity with slightly better, or at least comparable, outcomes. Despite the improvements achieved by the implementation of chemo-IMRT, different new strategies to further improve outcome and reduce toxicity need to be thoroughly investigated in prospective, preferably, randomized trials.
Authors: Terence T Sio; Huei-Kai Lin; Qiuling Shi; G Brandon Gunn; Charles S Cleeland; J Jack Lee; Mike Hernandez; Pierre Blanchard; Nikhil G Thaker; Jack Phan; David I Rosenthal; Adam S Garden; William H Morrison; C David Fuller; Tito R Mendoza; Radhe Mohan; Xin Shelley Wang; Steven J Frank Journal: Int J Radiat Oncol Biol Phys Date: 2016-02-18 Impact factor: 7.038
Authors: Andreas E Albers; Regina Grabow; Xu Qian; Masen D Jumah; Veit M Hofmann; Alexander Krannich; Gabriele Pecher Journal: Mol Clin Oncol Date: 2017-06-01
Authors: R Maquieira; S K Haerle; G F Huber; A Soltermann; S R Haile; S J Stoeckli; Martina A Broglie Journal: Eur Arch Otorhinolaryngol Date: 2015-06-10 Impact factor: 2.503
Authors: Katherine A Hutcheson; F Christopher Holsinger; Michael E Kupferman; Jan S Lewin Journal: Eur Arch Otorhinolaryngol Date: 2014-03-19 Impact factor: 2.503