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Title: Three-dimensional conformal radiotherapy for locally advanced (Stage II and worse) head-and-neck cancer: Dosimetric and clinical evaluation

Purpose: To evaluate the dosimetric parameters of three-dimensional conformal radiotherapy (3D-CRT) in locally advanced head-and-neck tumors (Stage II and above) and the effects on xerostomia. Methods and Materials: A total of 49 patients with histologically proven squamous cell cancer of the head and neck were consecutively treated with 3D-CRT using a one-point setup technique; 17 had larynx cancer, 12 oropharynx, 12 oral cavity, and 6 nasopharynx cancer; 2 had other sites of cancer. Of the 49 patients, 41 received postoperative RT and 8 definitive treatment. Also, 13 were treated with cisplatin-based chemotherapy before and during RT; in 6 cases, 5-fluorouracil was added. The follow-up time was 484-567 days (median, 530 days). Results: One-point setup can deliver 96% of the prescribed dose to the isocenter, to the whole planning target volume, including all node levels of the neck and without overdosages. The mean dose to the primary planning target volume was 49.54 {+-} 4.82 Gy (51.53 {+-} 5.47 Gy for larynx cases). The average dose to the contralateral parotid gland was approximately 38 Gy (30 Gy for larynx cases). The maximal dose to the spinal cord was 46 Gy. A Grade 0 Radiation Therapy Oncology Group/European Organization for Research and Treatmentmore » of Cancer xerostomia score corresponded to a mean dose of 30 Gy to one parotid gland. A lower xerostomia score with a lower mean parotid dose and longer follow-up seemed to give rise to a sort of functional recovery phenomenon. Conclusion: Three dimensional-CRT in head-and-neck cancers permits good coverage of the planning target volume with about 10-11 segments and one isocenter. With a mean dose of approximately 30 Gy to the contralateral parotid, we observed no or mild xerostomia.« less
Authors:
 [1] ;  [2] ;  [3] ;  [3] ;  [2] ;  [3] ;  [3] ;  [3]
  1. Department of Radiotherapy, AUSL Br-1, 'Di Summa-Perrino' Hospital, Brindisi (Italy) and National Research Council, IFC, Lecce (Italy). E-mail: portaluri@hotmail.com
  2. Department of Medical Physics, AUSL Br-1, 'Di Summa-Perrino' Hospital, Brindisi (Italy)
  3. Department of Radiotherapy, AUSL Br-1, 'Di Summa-Perrino' Hospital, Brindisi (Italy)
Publication Date:
OSTI Identifier:
20850218
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 66; Journal Issue: 4; Other Information: DOI: 10.1016/j.ijrobp.2006.03.014; PII: S0360-3016(06)00458-5; Copyright (c) 2006 Elsevier Science B.V., Amsterdam, Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CARCINOMAS; CHEMOTHERAPY; EVALUATION; GLANDS; HEAD; LARYNX; NECK; ORAL CAVITY; PATIENTS; PHARYNX; PLANNING; RADIATION DOSES; RADIOTHERAPY; SPINAL CORD; URACILS