Reduction of the dose to the elective neck in head and neck squamous cell carcinoma, a randomized clinical trial using intensity modulated radiotherapy (IMRT). Dosimetrical analysis and effect on acute toxicity.

摘要: Background and purpose A randomized trial was initiated to investigate whether a reduction of the dose elective nodal sites swallowing apparatus delivered by IMRT would result in acute late side effects without compromising tumor control. The aim this paper is report on dosimetrical analysis toxicity. Materials & methods Two-hundred patients were randomized. In standard arm, volumes (PTV elect) irradiated up an equivalent 50 Gy. experimental arm 40 Gy prescribed PTV elect. kept as low possible therapeutic (PTVther) coverage. Results No significant difference seen between both arms concerning ther median D95 PTVelect significantly lower (39.5 vs 49.8 Gy; p < 0.001). Concerning organs at risk, structures spinal cord reduced. There no Three months after radiotherapy there less grade ≥3 dysphagia (2% 11%; = 0.03). With follow-up 6 differences observed locoregional control, disease free survival or overall survival. Conclusions Using we able reduce several risk PTVther This resulted severe 3 radiotherapy. Further necessary these observations translate into benefit treatment related affecting outcome. © 2013 Elsevier Ireland Ltd. All rights reserved.