Simultaneous Integrated Boost Using Intensity-Modulated Radiotherapy Compared With Conventional Radiotherapy in Patients Treated With Concurrent Carboplatin and 5-Fluorouracil for Locally Advanced Oropharyngeal Carcinoma

Journal Article · Wed Feb 01 04:00:00 EST 2012 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/J.IJROBP.2010.10.061· OSTI ID:22055998

Clavel, Sebastien ^[1]; Nguyen, David H.A.; Fortin, Bernard ^[2]; Despres, Philippe ^[1]; Khaouam, Nader ^[2]; Donath, David ^[1]; Soulieres, Denis ^[3]; Guertin, Louis ^[4]; Nguyen-Tan, Phuc Felix ^[2]

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1. Department of Radiation Oncology, Centre Hospitalier de l'Universite de Montreal, Montreal, QC (Canada)
2. Department of Radiation Oncology, Hopital Maisonneuve-Rosemont, Montreal, QC (Canada)
3. Department of Medical Oncology, Centre Hospitalier de l'Universite de Montreal, Montreal, QC (Canada)
4. Department of Head and Neck Surgery, Centre Hospitalier de l'Universite de Montreal, Montreal, QC (Canada)

Purpose: To compare, in a retrospective study, the toxicity and efficacy of simultaneous integrated boost using intensity-modulated radiotherapy (IMRT) vs. conventional radiotherapy (CRT) in patients treated with concomitant carboplatin and 5-fluorouracil for locally advanced oropharyngeal cancer. Methods and Materials: Between January 2000 and December 2007, 249 patients were treated with definitive chemoradiation. One hundred patients had 70 Gy in 33 fractions using IMRT, and 149 received CRT at 70 Gy in 35 fractions. Overall survival, disease-free survival, and locoregional control were estimated using the Kaplan-Meier method. Results: Median follow-up was 42 months. Three-year actuarial rates for locoregional control, disease-free survival, and overall survival were 95.1% vs. 84.4% (p = 0.005), 85.3% vs. 69.3% (p = 0.001), and 92.1% vs. 75.2% (p < 0.001) for IMRT and CRT, respectively. The benefit of the radiotherapy regimen on outcomes was also observed with a Cox multivariate analysis. Intensity-modulated radiotherapy was associated with less acute dermatitis and less xerostomia at 6, 12, 24, and 36 months. Conclusions: This study suggests that simultaneous integrated boost using IMRT is associated with favorable locoregional control and survival rates with less xerostomia and acute dermatitis than CRT when both are given concurrently with chemotherapy.

• OSTI ID: 22055998
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 2 Vol. 82; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CARCINOMAS
CHEMOTHERAPY
DERMATITIS
HEAD
MULTIVARIATE ANALYSIS
NECK
PATIENTS
RADIOTHERAPY
TOXICITY
URACILS