Intensity-modulated radiotherapy in head and neck cancer: results of the prospective study GORTEC 2004-03.
作者： Ivan Toledano , Pierre Graff , Antoine Serre , Pierre Boisselier , René-Jean Bensadoun
DOI: 10.1016/J.RADONC.2011.12.010
关键词: Intensity modulated radiotherapy 、 Prospective cohort study 、 Surgery 、 Radiation therapy 、 Clinical trial 、 Cancer 、 Stage (cooking) 、 Radiology 、 Medicine 、 Head and neck cancer 、 Relative risk
摘要: Abstract Background and purpose In 2003, the French Authority for Health (HAS) recommended use of intensity modulated radiotherapy (IMRT) in prospective trial before its routine use. The Oncology Radiotherapy Group Head Neck Cancer (GORTEC) proposed to evaluate prospectively acute late toxicities, locoregional control overall survival patients treated head neck cancer (HNC) with IMRT bilateral irradiation. Materials methods Between 2002 2008, 208 HNC were 8 centres. There 38 nasopharynx, 117 oropharynx, 25 pharyngo-larynx, 24 oral cavity 4 unknown primary (28.5% stage I–II 71% Stage III–IV). Ninety-three (46%) had postoperative 78 (37.5%) received concurrent chemotherapy. doses 70Gy gross tumour, 66Gy high-risk sites 50Gy subclinical disease. Toxicities graded according RTOG–EORTC scales. Results median follow-up was 25.3months (range: 0.4–72months). 29 local–regional failures: in-field, three marginal one out-field. two-year loco-regional 86% 86.7%, respectively. At 18months, grade ⩾2 xerostomia 16.1%. A mean dose spared parotid below 28Gy led significantly less (8.5% vs 24%) a relative risk 1.2 [95% CI: 1.02–1.41, p =0.03]. Grade increased by approximately 3% per Gy up 28, then 7% above 33Gy. Conclusions HN seems reduce toxicities without jeopardising local survival.
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