Disease-control rates following intensity-modulated radiation therapy for small primary oropharyngeal carcinoma

Garden, Adam S.; Morrison, William H.; Wong, Pei Fong; Tung, S.; Rosenthal, David I.; Dong, Lei; Mason, B R; Perkins, George H.; Ang, K. Kian

doi:10.1016/j.ijrobp.2006.08.078

Cited by 130 publications

(92 citation statements)

References 20 publications

(32 reference statements)

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“…However, data are starting to emerge that suggests rates of mucositis and dysphagia may be higher with IMRT than with traditional CRT, particularly if the oral cavity and swallowing structures are not delineated as avoidance structures during IMRT planning [6]. Given concerns of high doses to the brachial plexus, we previously published a basic atlas to delineate this organ as an avoidance structure for the purpose of IMRT planning [2].…”

Section: Discussionmentioning

confidence: 99%

Intensity-modulated radiotherapy increases dose to the brachial plexus compared with conventional radiotherapy for head and neck cancer

Chen

Wh²,

Bq³

et al. 2011

BJR

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Objective: The preferential use of intensity-modulated radiotherapy (IMRT) over conventional radiotherapy (CRT) in the treatment of head and neck cancer has raised concerns regarding dose to non-target tissue. The purpose of this study was to compare dose-volume characteristics with the brachial plexus between treatment plans generated by IMRT and CRT using several common treatment scenarios. Method: The brachial plexus was delineated on radiation treatment planning CT scans from 10 patients undergoing IMRT for locally advanced head and neck cancer using a Radiation Therapy Oncology Group-endorsed atlas. No brachial plexus constraint was used. For each patient, a conventional three-field shrinking-field plan was generated and the dose-volume histogram (DVH) for the brachial plexus was compared with that of the IMRT plan. Results: The mean irradiated volumes of the brachial plexus using the IMRT vs the CRT plan, respectively, were as follows: V50 (18¡5 ml) vs (11¡6 ml), p50.01; V60 (6¡4 ml) vs (3¡3 ml), p50.02; V66 (3¡1 ml) vs (1¡1 ml), p50.04, V70 (0¡1 ml) vs (0¡1 ml), p50.68. The maximum point dose to the brachial plexus was 68.9 Gy (range 62.3-78.7 Gy) and 66.1 Gy (range 60.2-75.6 Gy) for the IMRT and CRT plans, respectively (p50.01). Conclusion: Dose to the brachial plexus is significantly increased among patients undergoing IMRT compared with CRT for head and neck cancer. Preliminary studies on brachial plexus-sparing IMRT are in progress.

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Section: Discussionmentioning

confidence: 99%

Intensity-modulated radiotherapy increases dose to the brachial plexus compared with conventional radiotherapy for head and neck cancer

Chen

Wh²,

Bq³

et al. 2011

BJR

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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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“…The 2-year locoregional control was 94%. 29 de Arruda et al published their single-institution experience to date in treating stage I-IV oropharyngeal cancer for 50 patients with a median followup of 18 months. 30 Most (86%) patients received concurrent chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

Intensity‐modulated chemoradiation for treatment of stage III and IV oropharyngeal carcinoma

Huang

Xia

Chuang

et al. 2008

Cancer

124

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BACKGROUND.Treatment outcomes for stage III and IV oropharyngeal carcinoma treated with intensity‐modulated radiotherapy (IMRT) and concurrent chemotherapy without prior surgical resection were reviewed.METHODS.Between April 2000 and September 2004, 71 patients underwent IMRT concurrent with chemotherapy without prior surgical resection for stage III and IV oropharyngeal carcinoma. Chemotherapy was platinum based. The gross tumor volume (GTV) received 70 Gy in 2.12 Gy per fraction. The high‐risk clinical tumor volume (CTV) received 59.4 Gy in 1.80 Gy per fraction, and the low‐risk CTV received 54 Gy in 1.64 Gy per fraction.RESULTS.With a median follow‐up of 33 months, the 3‐year local, regional, and locoregional progression‐free probabilities were 94%, 94%, and 90%, respectively. The 3‐year overall survival estimate was 83%. Locoregional failures occurred in the GTV in 7 patients. Acute grade 3 or 4 toxicity developed in 35 patients. A feeding gastrostomy was placed in 25 patients. Late xerostomia was grade 0 in 16 patients, grade 1 in 31 patients, and grade 2 in 24 patients at last follow‐up. No patients experienced grade 3 or 4 late toxicity, except for 1 who developed osteoradionecrosis of the mandible.CONCLUSIONS.Excellent local and regional control was achieved with IMRT and concurrent chemotherapy without prior surgical resection in the treatment of stage III and IV oropharyngeal carcinoma. Significant sparing of the parotid glands and other critical normal tissues was possible using IMRT with moderate acute toxicities and minimal severe late effects. Cancer 2008. © 2008 American Cancer Society.

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Disease-control rates following intensity-modulated radiation therapy for small primary oropharyngeal carcinoma

Abstract: Background-The purpose of this study was to assess the ability of intensity-modulated radiation therapy (IMRT) to achieve favorable disease-control rates while minimizing parotid gland doses in patients treated for small primary tumors of the oropharynx.

Cited by 130 publications

References 20 publications

Intensity-modulated radiotherapy increases dose to the brachial plexus compared with conventional radiotherapy for head and neck cancer

Intensity-modulated radiotherapy increases dose to the brachial plexus compared with conventional radiotherapy for head and neck cancer

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

Intensity‐modulated chemoradiation for treatment of stage III and IV oropharyngeal carcinoma

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