Intensity-Modulated Radiotherapy for Head-and-Neck Cancer in the Community Setting

Journal Article · Sat Nov 15 04:00:00 EST 2008 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2008.02.016· OSTI ID:21172459

Seung, Steven ^[1]; Bae, Joseph ^[2]; Solhjem, Matthew; Bader, Stephen; Gannett, David; Hansen, Eric K; Louie, Jeannie; Underhill, Kelly Cha Christine ^[1]

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1. Division of Radiation Oncology, Oregon Clinic, Portland, OR (United States)
2. Lewis and Clark College, Portland, OR (United States)

Purpose: To review outcomes with intensity-modulated radiation therapy (IMRT) in the community setting for the treatment of nasopharyngeal and oropharyngeal cancer. Methods and Materials: Between April 2003 and April 2007, 69 patients with histologically confirmed cancer of the nasopharynx and oropharynx underwent IMRT in our practice. The primary sites included nasopharynx (11), base of tongue (18), and tonsil (40). The disease stage distribution was as follows: 2 Stage I, 11 Stage II, 16 Stage III, and 40 Stage IV. All were treated with a simultaneous integrated boost IMRT technique. The median prescribed doses were 70 Gy to the planning target volume, 59.4 Gy to the high-risk subclinical volume, and 54 Gy to the low-risk subclinical volume. Forty-five patients (65%) received concurrent chemotherapy. Toxicity was graded according to the Radiation Therapy Oncology Group toxicity criteria. Progression-free and overall survival rates were estimated with the Kaplan-Meier product-limit method. Results: Median duration of follow-up was 18 months. The estimated 2-year local control, regional control, distant control, and overall survival rates were 98%, 100%, 98%, and 90%, respectively. The most common acute toxicities were dermatitis (32 Grade 1, 32 Grade 2, 5 Grade 3), mucositis (8 Grade 1, 33 Grade 2, 28 Grade 3), and xerostomia (0 Grade 1, 29 Grade 2, 40 Grade 3). Conclusions: Intensity-modulated radiotherapy in the community setting can be accomplished safely and effectively. Systematic internal review systems are recommended for quality control until sufficient experience develops.

• OSTI ID: 21172459
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 4 Vol. 72; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CARCINOMAS
CHEMOTHERAPY
DERMATITIS
HEAD
LYMPHATIC SYSTEM
NECK
PATIENTS
PHARYNX
QUALITY CONTROL
RADIATION DOSES
RADIATION HAZARDS
RADIOTHERAPY
REVIEWS
TONGUE
TOXICITY