A phase I study of dose-escalated chemoradiation with accelerated intensity modulated radiotherapy in locally advanced head and neck cancer

摘要: Background and purpose: Intensity modulated radiotherapy (IMRT) allows the delivery of higher more homogeneous radiation dose to head neck tumours. This study aims determine safety dose-escalated chemo-IMRT for larynx preservation in locally advanced cancer. Methods: Patients with T2–4, N1–3, M0 squamous cell carcinoma or hypopharynx were treated a simultaneous-boost IMRT. Two levels (DL) tested: In DL 1, 63 Gy/28F was delivered primary tumour involved nodes 51.8 elective nodes. 2, doses 67.2 56 Gy/28F, respectively, representing 9% escalation primary. All patients received 2 cycles neoadjuvant cisplatin 5-fluorouracil, concomitant cisplatin. Acute (NCICTCv.2.0) late toxicity (RTOG modified LENTSOM) collected. Results: Thirty entered, 15 each level. completed treatment schedule. incidences acute G3 toxicities 27% (pain), 20% (radiation dermatitis), 0% (xerostomia) 67% required gastrostomy tubes. For corresponding 40%, 20%, 7%, 87%. dysphagia pain persisted longer 2. With regard mucositis, prolonged healing time found, prevalence G2 58% week 10. No grade 4 observed. At 6 months, 1 patient had (dysphagia). limiting found. Complete response rates 80% 87% Conclusion: Moderately accelerated is safe feasible good compliance acceptable toxicity. Dose possible without significant difference Longer follow-up incidence toxicities, control rates. c 2007 Elsevier Ireland Ltd. rights reserved. Radiotherapy Oncology 85 (2007) 36–41.