A Phase I/II Study of Altered Fractionated IMRT Alone for Intermediate T-Stage Oropharyngeal Carcinoma

Abstract

While the routine clinical use of this exploratory schedule is discouraged, it may represent the basis for future developments.

Hyperfractionated accelerated radiotherapy with concomitant integrated boost of 70–75 Gy in 5 weeks for advanced head and neck cancer

“…Some available radiobiological predictions based on the linear-quadratic model define the risk of excessive acute toxicity [11]; however, there is a grey zone that remains to be clarified. To the best our knowledge, only one study has evaluated the feasibility of hyperfractionated accelerated RT with integratedboost IMRT [19]. The present dose-escalation study contributes to the search for the maximum tolerated dose when single modality RT is used in the era of highly conformal techniques.…”

Survival of patients with head and neck cancer

“…In 2006, according to the Robert Koch Institute, 10,000 women and 25,000 men were affected with cancer of the oral cavity and pharynx in Germany. The prognosis depends on whether the tumor is detected at an early stage and the application of an extensive treatment is possible [8,29].…”

“…Both scales are well established and have been shown to correlate well with patient survival [30]. However, comorbid illness(es) and tumor-specific impairments are the most important causes of treatment selection bias because patients with relevant comorbidities are at higher risk for complications in case of more aggressive treatment approaches such as radical surgery or multimodal oncological therapy [8]. In addition, patients with comorbidities are often excluded from clinical trials.…”

Optimising nutrition support in patients with head and neck cancer

“…Research relating to impact of H-IMRT on nutrition outcomes and tube feeding requirements is sparse (Chatterjee et al, 2011), although there are some studies reporting on outcomes following linear accelerator based IMRT (Caudell et al, 2010;Gunn et al, 2010;Studer et al, 2010). The current evidence indicates that weight loss is a recurring problem, despite advancing radiotherapy techniques, which supports the ongoing essential need for nutrition intervention.…”

“…This has resulted in a reduction in longterm dysphagia and xerostomia (Kam et al, 2007;Nutting et al, 2011;Pow et al, 2006), Consequently, it is anticipated that a patient's nutritional intake would improve, however the studies are yet to measure this as a specific primary outcome to demonstrate this theoretical benefit, and high rates of weight loss and tube feeding during and post-treatment have still been reported (Caudell et al, 2010;Gunn, Endres, Parker, Sormani, & Sanguineti, 2010;Studer et al, 2010). Therefore recommendations for nutrition intervention have not changed.…”