Helical tomotherapy: an innovative radiotherapy technique for the treatment of locally advanced oropharynx and inoperable oral cavity carcinoma

BACKGROUND: To report our initial clinical experience of helical tomotherapy (HT) in the treatment of locally advanced oropharynx and inoperable oral cavity cancer. METHODS: Between February 2008 and January 2011, 24 consecutive patients, 15 with oropharyngeal cancer and 9 with oral cavity cancer were treated with exclusive radiotherapy or concomitant chemoradiotherapy. Simultaneous integrated boost (SIB) in 30 fractions scheme was prescribed to all patients, using Helical Tomotherapy. Doses administered to primary tumor, oropharynx/oral cavity and positive lymph-nodes and negative lymph-nodes were 66–67.5 Gy, 60–63 Gy and 54 Gy, respectively. RESULTS: Complete response rate for the oropharynx and the oral cavity group was 86.7% and 77.8%, respectively. The 1 and 2-year Overall Survival (OS) and Disease Free Survival (DFS) rate for the oropharynx group was 92.9%, 85.1%, 92.9% and 77.4% respectively. For the oral cavity group, 1 and 2-year OS and DFS rates were 55.6%, 55.6%, 75% and 75%, respectively. No patient developed grade ≥3 mucositis, dysphagia or dermatitis. The maximum late-toxicity grade observed was 2, for all the variables examined. CONCLUSIONS: HT appears to achieve encouraging clinical outcomes in terms of response, survival and toxicity rates.