A comparison of intensity-modulated radiation therapy and concomitant boost radiotherapy in the setting of concurrent chemotherapy for locally advanced oropharyngeal carcinoma.

摘要: Purpose: The aim of this study was to compare toxicity/efficacy conventional radiotherapy using delayed accelerated concomitant boost (CBRT) vs. intensity-modulated (IMRT) in the setting concurrent chemotherapy (CT) for locally advanced oropharyngeal carcinoma. Methods and Materials: Between September 1998 June 2004, a total 293 consecutive patients were treated at our institution cancer oropharynx. Of these, 112 had Stage III/IV disease squamous cell histology. In all, 41 with IMRT/CT 71 CBRT/CT, both median dose 70 Gy. Most common CT planned two cycles given every 3 4 weeks cisplatin, 100 mg/m 2 i.v., but an additional cycle IMRT when possible. Both groups well-matched all prognostic factors. Results: Median follow-up 46 months (range, 3–93 months) CBRT 31 20–64 group. Three-year actuarial local-progression–free, regional-progression-free, locoregional progression-free, distant-metastases–free, disease-free, overall survival rates 85% 95% ( p = 0.17), 94% 0.90), 82% 92% 0.18), 86% 0.78), 76% 0.57), 81% 91% 0.10) patients, respectively. Three died treatment-related toxicity group none undergoing IMRT. At years, 4% 21% dependent on percutaneous endoscopic gastrostomy 0.02). Among those who ≥20 follow-up, there significant difference Grade ≥2 xerostomia as defined by criteria Radiation Therapy Oncology Group, 67% 12% 0.02), arm. Conclusion: carcinoma, results lower similar treatment outcomes compared CBRT.