Comparison three-dimensional conformal radiotherapy versus intensity modulated radiation therapy in local control of head and neck cancer.
Background: About 74% of head and neck cancer (HNC) patients need to undergo either definitive or postoperative radiation therapy because of aggressive nature of disease. The transition from two-dimensional conventional radiotherapy to three-dimensional conformal radiotherapy (3D-CRT) and further te...
| Publicado en: | Journal of Cancer Research & Therapeutics Vol. 14; no. 4; pp. 1412 - 1418 |
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| Autores principales: | , , , |
| Formato: | Journal Article |
| Publicado: |
Wolters Kluwer India Pvt Ltd
Oct2018
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=133277310&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 133277310 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09731482 1BS3 jtl: Journal of Cancer Research & Therapeutics issn: 09731482 maglogo: N pubinfo: dt: Oct2018 vid: 14 iid: 4 pid: 16919 pub: Wolters Kluwer India Pvt Ltd artinfo: ui: 133277310 133277310 NLM30488865 10.4103/jcrt.JCRT_725_17 NLM30488865 133277310 ppf: 1412 ppct: 6 formats: tig: atl: Comparison three-dimensional conformal radiotherapy versus intensity modulated radiation therapy in local control of head and neck cancer. aug: au: Ghosh, Gopa Gupta, Gaurav Malviya, Anupam Saroj, Dinesh affil: Department of Radiotherapy, Chirayu Medical College and Hospital, Bhopal, Madhya Pradesh, India sug: subj: Head and Neck Neoplasms Pathology Head and Neck Neoplasms Radiotherapy Postoperative Care Methods Mouth Neoplasms Radiotherapy Xerostomia Radiotherapy Female Xerostomia Drug Therapy Prospective Studies Middle Age Cisplatin Therapeutic Use Radiotherapy, Conformal Methods Radiation Dosage Prognosis Xerostomia Pathology Male Radiotherapy, Computer-Assisted Methods Mouth Neoplasms Drug Therapy Head and Neck Neoplasms Drug Therapy Scales Middle Aged: 45-64 years Female Male ab: Background: About 74% of head and neck cancer (HNC) patients need to undergo either definitive or postoperative radiation therapy because of aggressive nature of disease. The transition from two-dimensional conventional radiotherapy to three-dimensional conformal radiotherapy (3D-CRT) and further technological evolutions led to the successful clinical implementation of intensity modulated radiation therapy (IMRT), which constitutes an evolution of 3D-CRT. The IMRT technique gives the ability to create treatment fields with varying beam intensity using inverse planning and optimization algorithms to treat irregularly shaped target volumes with high precision. IMRT is in existence in clinical practice since 1995. Since then, presuming its clinical benefit a significant amount of patients has been treated by this technique. PARSPORT was the first multi-institutional prospective trial comparing IMRT with conventional RT in the treatment of HNC. It has shown a reduction in severe xerostomia but no difference in other toxicity and locoregional control after 24 months' follow or overall survival. Except for early T1, 2 N0 stages, the prognosis for patients with oral cavity cancer (OCC) is dismal than for carcinoma in other sites of the head and neck (HNC).Aim: The aim of this study was to assess the outcome of OCC following IMRT.Materials and Methods: Between January 2013 and January 2015, 40 patients of carcinoma buccal mucosa and carcinoma alveolus were treated by postoperative (19) or definitive (21) radiation therapy by IMRT technique. Of these, 28 patients (70%) presented with locally advanced T3/4 or recurrent tumor. Total radiation doses delivered was between 60 and 70 Gray at 2 Gray/fraction. Of these 31 patients (78%) has received concurrent cisplatin-based chemotherapy. Another group of 42 similar patients treated by 3D-CRT as definitive or postoperative adjuvant treatment over the same period has been selected. Comparisons were performed between these two groups.Statistical Analysis: Data were entered into Excel spreadsheet and expressed as mean and standard deviation for deriving P value, and unpaired t-test was used to calculate 95% confidence interval. Local control (LC) was analyzed using Kaplan-Meier curve. Of all assessed treatment subgroups, LC rate was highest for patients treated with postoperative IMRT (89% LC at 2 years) followed by postoperative 3D-CRT patients (79% LC at 2 years); and finally, poorest LC rates (43% and 32% at 2 years) were seen in definitively irradiated patients with IMRT and 3D-CRT, respectively. LC rate for T1 stage (83%, n = 6) was significantly higher, than that for T2-4 (LC 55%, n = 76) as expected.Conclusion: Postoperative IMRT of carcinoma buccal mucosa and alveolus resulted in the highest LC rate of all the treatment subgroups assessed hence should be generously recommended in such cases especially ones with unfavorable features such as close resection margin, nodal involvement, locally advanced tumor (>T1N0), or recurrent disease, respectively. Despite definitive IMRT, locoregional control in carcinoma buccal mucosa and alveolus remain unsatisfactory, comparable to that following definitive 3D-CRT. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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