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Characteristics of response of oral and pharyngeal mucosa in patients receiving chemo-IMRT for head and neck cancer using hypofractionated accelerated radiotherapy

Abstract

Purpose: This study describes the acute response of oral and pharyngeal mucosa to chemo-IMRT schedules using different doses per fraction. Materials and methods: Patients, treated in prospective trials of concomitant chemo-IMRT with 2.17 Gy, 2.25 Gy and 2.4 Gy per fraction and identical dose of cisplatin, were included in this study. Acute toxicity was recorded prospectively using the CTCAE v2.0. We describe the incidence and prevalence of grade 3 oral mucositis and dysphagia over time and report the influence of overall treatment time (OTT). The association between the lengths of pharyngeal mucosa receiving 50 Gy (L50) and 60 Gy (L60) and grade 3 dysphagia was tested. Results: The incidence and the peak prevalence of grade 3 dysphagia were significantly higher in patients receiving 2.4 Gy per fraction. The peak prevalence of grade 3 dysphagia was higher and the recovery was slower in patients with lower OTT (median 38 days vs. 42 days) treatment. There was a significant correlation between L50, L60 and grade 3 dysphagia. A L50 and L60 greater than 8 cm resulted in greater than 60% and 70% incidence of grade 3 dysphagia, respectively. Conclusion: The length of pharyngeal mucosa receiving doses close to the prescription dose correlates  More>>
Publication Date:
Oct 15, 2010
Product Type:
Journal Article
Resource Relation:
Journal Name: Radiotherapy and Oncology; Journal Volume: 97; Journal Issue: 1; Other Information: DOI: 10.1016/j.radonc.2010.08.013; PII: S0167-8140(10)00494-9; Copyright (c) 2010 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; FRACTIONATED IRRADIATION; HEAD; MUCOUS MEMBRANES; NECK; NEOPLASMS; PHARYNX; RADIOTHERAPY; TOXICITY; BODY; DIGESTIVE SYSTEM; DISEASES; IRRADIATION; MEDICINE; MEMBRANES; NUCLEAR MEDICINE; ORGANS; RADIOLOGY; RESPIRATORY SYSTEM; THERAPY
OSTI ID:
21435311
Country of Origin:
Ireland
Language:
English
Other Identifying Numbers:
Journal ID: ISSN 0167-8140; RAONDT; TRN: IE10R0308030816
Availability:
Available from http://dx.doi.org/10.1016/j.radonc.2010.08.013
Submitting Site:
INIS
Size:
page(s) 86-91
Announcement Date:
Jun 04, 2011

Citation Formats

Bhide, Shreerang A., E-mail: sabhide@yahoo.co [Royal Marsden Hospital, Sutton, London (United Kingdom), Institute of Cancer Research, Sutton, London (United Kingdom)], Gulliford, Sarah, Fowler, Jack, Department of Medical Physics, University of Wisconsin, Madison (United States)], Rosenfelder, Nicola, Newbold, Katie, Harrington, Kevin J, Nutting, Christopher M, and Institute of Cancer Research, Sutton, London (United Kingdom)]. Characteristics of response of oral and pharyngeal mucosa in patients receiving chemo-IMRT for head and neck cancer using hypofractionated accelerated radiotherapy. Ireland: N. p., 2010. Web. doi:10.1016/j.radonc.2010.08.013.
Bhide, Shreerang A., E-mail: sabhide@yahoo.co [Royal Marsden Hospital, Sutton, London (United Kingdom), Institute of Cancer Research, Sutton, London (United Kingdom)], Gulliford, Sarah, Fowler, Jack, Department of Medical Physics, University of Wisconsin, Madison (United States)], Rosenfelder, Nicola, Newbold, Katie, Harrington, Kevin J, Nutting, Christopher M, & Institute of Cancer Research, Sutton, London (United Kingdom)]. Characteristics of response of oral and pharyngeal mucosa in patients receiving chemo-IMRT for head and neck cancer using hypofractionated accelerated radiotherapy. Ireland. doi:10.1016/j.radonc.2010.08.013.
Bhide, Shreerang A., E-mail: sabhide@yahoo.co [Royal Marsden Hospital, Sutton, London (United Kingdom), Institute of Cancer Research, Sutton, London (United Kingdom)], Gulliford, Sarah, Fowler, Jack, Department of Medical Physics, University of Wisconsin, Madison (United States)], Rosenfelder, Nicola, Newbold, Katie, Harrington, Kevin J, Nutting, Christopher M, and Institute of Cancer Research, Sutton, London (United Kingdom)]. 2010. "Characteristics of response of oral and pharyngeal mucosa in patients receiving chemo-IMRT for head and neck cancer using hypofractionated accelerated radiotherapy." Ireland. doi:10.1016/j.radonc.2010.08.013. https://www.osti.gov/servlets/purl/10.1016/j.radonc.2010.08.013.
@misc{etde_21435311,
title = {Characteristics of response of oral and pharyngeal mucosa in patients receiving chemo-IMRT for head and neck cancer using hypofractionated accelerated radiotherapy}
author = {Bhide, Shreerang A., E-mail: sabhide@yahoo.co [Royal Marsden Hospital, Sutton, London (United Kingdom), Institute of Cancer Research, Sutton, London (United Kingdom)], Gulliford, Sarah, Fowler, Jack, Department of Medical Physics, University of Wisconsin, Madison (United States)], Rosenfelder, Nicola, Newbold, Katie, Harrington, Kevin J, Nutting, Christopher M, and Institute of Cancer Research, Sutton, London (United Kingdom)]}
abstractNote = {Purpose: This study describes the acute response of oral and pharyngeal mucosa to chemo-IMRT schedules using different doses per fraction. Materials and methods: Patients, treated in prospective trials of concomitant chemo-IMRT with 2.17 Gy, 2.25 Gy and 2.4 Gy per fraction and identical dose of cisplatin, were included in this study. Acute toxicity was recorded prospectively using the CTCAE v2.0. We describe the incidence and prevalence of grade 3 oral mucositis and dysphagia over time and report the influence of overall treatment time (OTT). The association between the lengths of pharyngeal mucosa receiving 50 Gy (L50) and 60 Gy (L60) and grade 3 dysphagia was tested. Results: The incidence and the peak prevalence of grade 3 dysphagia were significantly higher in patients receiving 2.4 Gy per fraction. The peak prevalence of grade 3 dysphagia was higher and the recovery was slower in patients with lower OTT (median 38 days vs. 42 days) treatment. There was a significant correlation between L50, L60 and grade 3 dysphagia. A L50 and L60 greater than 8 cm resulted in greater than 60% and 70% incidence of grade 3 dysphagia, respectively. Conclusion: The length of pharyngeal mucosa receiving doses close to the prescription dose correlates with grade 3 dysphagia. It was observed that incidence of grade 3 dysphagia was lower and recovery from it was quicker in patients with greater OTT.}
doi = {10.1016/j.radonc.2010.08.013}
journal = {Radiotherapy and Oncology}
issue = {1}
volume = {97}
place = {Ireland}
year = {2010}
month = {Oct}
}