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

Lee, Nancy Y.; Arruda, Fernando Freire de; Puri, Dev R.; Wolden, Suzanne L.; Narayana, Ashwatha; Mechalakos, James; Venkatraman, Ennapadam; Kraus, Dennis H.; Shaha, Ashok R.; Shah, Jatin P.; Pfister, David G.; Zeléfsky, Michael J.

doi:10.1016/j.ijrobp.2006.06.040

Cited by 148 publications

(104 citation statements)

References 39 publications

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“…IMRT results in better dose conformation to the PTV and improved sparing of adjacent uninvolved normal tissues compared with conventional radiotherapy. Numerous studies showed a reduction in the incidence and severity of xerostomia following parotid-sparing IMRT [19][20][21][22][23][24][25][26][27][28][29][30], with post-treatment recovery of saliva production and resultant improvement in patient-reported quality of life [31]. Three randomised controlled trials comparing parotid-sparing IMRT and conventional radiotherapy were reported [12,32,33].…”

Section: Discussion and Literature Reviewmentioning

confidence: 99%

Interobserver variation in parotid gland delineation: a study of its impact on intensity-modulated radiotherapy solutions with a systematic review of the literature

Loo

Martin²,

Smith³

et al. 2012

The British Journal of Radiology

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Objectives: This study evaluates the interobserver variation in parotid gland delineation and its impact on intensity-modulated radiotherapy (IMRT) solutions. Methods: The CT volumetric data sets of 10 patients with oropharyngeal squamous cell carcinoma who had been treated with parotid-sparing IMRT were used. Four radiation oncologists and three radiologists delineated the parotid gland that had been spared using IMRT. The dose-volume histogram (DVH) for each study contour was calculated using the IMRT plan actually delivered for that patient. This was compared with the original DVH obtained when the plan was used clinically. Results: 70 study contours were analysed. The mean parotid dose achieved during the actual treatment was within 10% of 24 Gy for all cases. Using the study contours, the mean parotid dose obtained was within 10% of 24 Gy for only 53% of volumes by radiation oncologists and 55% of volumes by radiologists. The parotid DVHs of 46% of the study contours were sufficiently different from those used clinically, such that a different IMRT plan would have been produced. Conclusion: Interobserver variation in parotid gland delineation is significant. Further studies are required to determine ways of improving the interobserver consistency in parotid gland definition.

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Section: Discussion and Literature Reviewmentioning

confidence: 99%

Interobserver variation in parotid gland delineation: a study of its impact on intensity-modulated radiotherapy solutions with a systematic review of the literature

Loo

Martin²,

Smith³

et al. 2012

The British Journal of Radiology

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“…15,16 It does appear that chronic toxicity is decreased with these modalities, specifically chronic xerostomia. This is fairly significant and hopefully will translate into a better quality of life for patients.…”

Section: Discussionmentioning

confidence: 99%

Randomized phase 2 study of concomitant chemoradiotherapy using weekly carboplatin/paclitaxel with or without daily subcutaneous amifostine in patients with locally advanced head and neck cancer

Haddad

Sonis

Posner

et al. 2009

Cancer

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We established a polymerization condition of 3‐hydroxycinnamic acid, 3HCA, having photoreactive units over all the main chains. The polymers showed two types of photoreaction, that is, intramolecular E–Z isomerization and interchain [2 + 2] cycloaddition. Spectroscopic studies showed that the rate of the isomerization was higher than that of the cycloaddition. Although the original fiber was very brittle, the short‐time UV‐irradiation made the fiber softer and more elastic because the chain bending by the isomerization preferentially occurred. On the other hand, the long‐time irradiation made the fiber harder because of the cross‐linking by the cycloaddition, and simultaneously enhanced the elasticity. Besides we found that the cast film of P3HCA showed a photo‐bending behavior with the convex surface facing the UV‐lamp by the initial E–Z isomerization. © 2010 Wiley Periodicals, Inc. J Polym Sci Part A: Polym Chem, 2011

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“…Since the majority of deaths occurring in the first 5 years following diagnosis are attributed to primary cancer, further improvements in therapy would yield meaningful improvements in overall survival (19). The improved prognosis associated with oropharyngeal cancers in recent years may be related to increased utilization of concurrent chemoradiation, technological advances in radiation delivery and the increasing prevalence of HPV-related tumors (5,9,12). Caucasian ethnicity and high grade tumors have both been associated with HPV-related tumors and likely account for some of the improved prognosis observed in those subgroups (13,20).…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of base of tongue and tonsil cancer in younger patients has increased dramatically over the past three decades (4). Several strategies designed to improve locoregional control for locally advanced oropharyngeal cancers, including concurrent chemoradiotherapy, intensity modulated radiation therapy and altered fractionation radiation therapy, have been extensively investigated (5)(6)(7)(8)(9). However, curing the index cancer eliminates only one of several mortality risks faced by these patients (10).…”

Section: Introductionmentioning

confidence: 99%

Competing causes of death in patients with oropharyngeal cancer treated with radiotherapy

Kao

Lau

Tong

et al. 2012

Experimental and Therapeutic Medicine

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Abstract. Radiation with or without chemotherapy is considered the mainstay of treatment for the majority of patients with oropharyngeal cancer. The goal of this study was to analyze competing causes of mortality in patients with oropharyngeal cancer with long-term follow-up. We queried the Surveillance, Epidemiology and End Results (SEER) database and identified 3728 patients with oropharyngeal cancer treated between 1988 and 2001 with definitive radiotherapy. We analyzed predictors of overall survival and risks of mortality from index oropharyngeal cancer, second primary cancer, cardiovascular disease and other causes using a cumulative incidence analysis and Cox multivariate analysis. With a median follow-up of 6.8 years, the 5-and 10-year overall survival was 37 and 22%, respectively. At 5 years, the risk of mortality from primary oropharyngeal cancer was 35%. Between years 3 and 10, 69% of mortalities were attributed to causes other than the index cancer. Despite advances in the non-surgical treatment of oropharyngeal cancer, patients remain at significant risk of cancer-and non-cancer-related mortality.

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

Cited by 148 publications

References 39 publications

Interobserver variation in parotid gland delineation: a study of its impact on intensity-modulated radiotherapy solutions with a systematic review of the literature

Interobserver variation in parotid gland delineation: a study of its impact on intensity-modulated radiotherapy solutions with a systematic review of the literature

Randomized phase 2 study of concomitant chemoradiotherapy using weekly carboplatin/paclitaxel with or without daily subcutaneous amifostine in patients with locally advanced head and neck cancer

Competing causes of death in patients with oropharyngeal cancer treated with radiotherapy

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