Adjuvant simultaneous integrated boost IMRT for patients with intermediate- and high-risk head and neck cancer: Outcome, toxicities and patterns of failure

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

“…However, the pattern of toxicity profile in the current study appears comparable to the rates of grade 2 and 3 mucositis (~44% and 28%), dysphagia (~25% and 28%) and ≥ grade 2 xerostomia (~72%) reported by Toledano et al (Toledano et al, 2012) in the prospective GORTEC 2004-03 study. Reports of mucositis in studies with mixed tumour sites vary significantly with several studies reporting similar (15-32%) grade 3 rates to those in our study (Lambrecht, Nevens, & Nuyts, 2013;Stromberger et al, 2014;Studer et al, 2006), compared with a much higher rate of 82% (Van Gestel, Van Den Weyngaert, Schrijvers, & Weyler, 2011), and much lower rates of 0-6% (Ghosh-Laskar et al, 2015;Gupta et al, 2012).…”

“…However, these 2 studies had much higher rates of grade 2 mucositis and the difference in reports may reflect a difference in speech pathologist vs medical officer scoring. Grade 2 xerostomia rates were comparable (Ghosh-Laskar et al, 2015;Gupta et al, 2012), however, grade 3 dysphagia reports also vary widely from 10-74% (Gupta et al, 2012;Lambrecht et al, 2013;Stromberger et al, 2014;Studer et al, 2006), with the 41% found in this study falling in the midrange. It is therefore difficult to draw firm conclusions regarding the toxicity profiles of HNC Further large cohort prospective studies documenting the range of treatment related toxicities is required to accurately determine the possible benefit of H-IMRT in reducing dysphagia and related toxicities compared with traditional IMRT.…”

Evaluation of purely accelerated six fractions per week radiotherapy in postoperative oral cavity squamous cell carcinoma

“…Our study had an acute skin toxicity rate of 17.5%, which is consistent with the literature and it appeared in the third and fourth weeks in most of the cases. Grade 3 dysphagia has been reported in the range of 10‐33% cases in different studies . We found grade 3 pharynx and esophageal toxicity in 25% cases, which started during the third week of treatment.…”

“…The appropriate dose, fractionation, and OTTs for different risk categories of postoperative OCSCC patients continue to be a matter of scientific deliberation and evaluation. Treatment intensification has been attempted in postoperative OCSCC by different methods, including accelerated PORT by concomitant boost techniques, using acceleration with CTRT, split‐course RT, and IMRT techniques (Table ). Although there are several published studies on acceleration in PORT with or without chemotherapy, there is lack of literature addressing purely accelerated PORT.…”

Intensified intensity-modulated radiotherapy in anal cancer with prevalent HPV p16 positivity

“…This approach has its advantages compared to sequential dosage increment, namely: the possibility to deliver different fraction doses to different volumes, shorten overall treatment time (OTT), and guarantee better coverage of Gross Tumor Volume (GTV) with non-target tissue sparing. SIB use has also been investigated in diseases other than anal canal cancer, such as head and neck cancer and cervical cancer, and where it has been demonstrated to be feasible and act to reduce acute toxicity [6][7][8] . Here we present the results of a study carried out with an intensified radiotherapy regimen associated with chemotherapy that was applied in order to improve oncologic efficacy and reduce overall acute toxicity in patients with squamous cell carcinoma of the anal canal treated at our center.…”