Xerostomia in patients treated for oropharyngeal carcinoma: Comparing linear accelerator-based intensity-modulated radiation therapy with helical tomotherapy

Abstract

This retrospective series suggests that using HT can better spare the parotid glands while respecting quantitative analysis of normal tissue effects in the clinic (QUANTEC)'s criteria.

Helical intensity‐modulated radiotherapy with concurrent chemotherapy for oropharyngeal squamous cell carcinoma: A prospective investigation of acute swallowing and toxicity patterns

“…Similarly, Chen et al 47 found no statistical difference in acute mucositis, dysphagia, and xerostomia rates between helical tomotherapy IMRT and a step-and-shoot IMRT in a study of 149 patients with mixed tumor sites. In contrast to this, Fortin et al 34 reported a statistically significant improvement in observer and patient-reported xerostomia with helical tomotherapy-based IMRT versus linac-based IMRT in their retrospective study of 119 patients with oropharyngeal SCC. Although limited, direct comparison of the current results with key selected literature for patients with oropharyngeal SCC and oropharyngeal cancer undergoing traditional IMRT with concurrent chemotherapy, can also be seen in Table 4.…”

“…[2][3][4] In the field of radiotherapy, technology has continued to evolve since the introduction of 3D conformal radiation. 31,33,34 Despite the theoretical potential to assist in reducing the extent of radiation dose, there is as yet a limited number of studies reporting swallowing and toxicity outcomes for patients with oropharyngeal SCC undergoing helical IMRT. This work has led to the development of parotid-sparing IMRT and swallow-sparing IMRT techniques.…”

“…[30][31][32][33] Planning studies have reported a superiority of helical IMRT to reduce the radiation dose to critical swallowing structures in patients with oropharyngeal SCC. 31,33,34 Despite the theoretical potential to assist in reducing the extent of radiation dose, there is as yet a limited number of studies reporting swallowing and toxicity outcomes for patients with oropharyngeal SCC undergoing helical IMRT. The studies that have been conducted are largely retrospective, reporting a limited number of patient outcomes, primarily mucositis as a "maximum incidence" figure only, and dysphagia outcomes are rarely documented.…”

Dysphagia and related toxicity in patients with head and neck cancer receiving helical intensity modulated radiotherapy +/- chemotherapy: Implications for speech pathology management

“…Proponents of this approach describe the potential to achieve greater homogeneity of dose and control of dose distributions using steep dose gradients to minimise volumes received by healthy tissue without compromising target coverage (Fiorino et al, 2006;Gielda et al, 2010;Murthy et al, 2010;Van Gestel, Van Vliet-Vroegindeweij, et al, 2013). Studies have now demonstrated superior parotid sparing with reduced xerostomia incidence with the use of H-IMRT compared to linac based IMRT (Fortin et al, 2014;Kimura et al, 2016).…”

“…Theoretical H-IMRT planning and dosimetry studies describe the potential for improved normal tissue sparing through steep dose gradients in different directions, greater homogeneity of dose control and increased precision of dose distributions whilst achieving better target coverage (Fiorino et al, 2006;Gielda et al, 2010;Murthy et al, 2010;Van Gestel, Van Vliet-Vroegindeweij, et al, 2013). Planning studies have reported a superiority of H-IMRT to reduce the radiation dose to critical swallowing structures in patients with OPSCC (Fortin et al, 2014;Gielda et al, 2010;Van Gestel, Van Vliet-Vroegindeweij, et al, 2013). Despite the theoretical potential to assist in reducing the extent of radiation dose, there is as yet a limited number of studies reporting swallowing and toxicity outcomes for OPSCC patients undergoing H-IMRT.…”