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Comparison of 3D Confromal Radiotherapy and Intensity Modulated Radiotherapy with or without Simultaneous Integrated Boost during Concurrent Chemoradiation for Locally Advanced Head and Neck Cancers

OBJECTIVE: Radiotherapy techniques have evolved from 3D conformal radiotherapy (3D-CRT) to intensity modulated radiotherapy (IMRT) where boost fields are delivered either sequentially (IMRTseq) or with a simultaneous integrated boost (IMRT+SIB). Our goal was to compare the outcomes of patients treat...

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Detalles Bibliográficos
Autores principales: Spiotto, Michael T., Weichselbaum, Ralph R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3979891/
https://www.ncbi.nlm.nih.gov/pubmed/24714187
http://dx.doi.org/10.1371/journal.pone.0094456
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author Spiotto, Michael T.
Weichselbaum, Ralph R.
author_facet Spiotto, Michael T.
Weichselbaum, Ralph R.
author_sort Spiotto, Michael T.
collection PubMed
description OBJECTIVE: Radiotherapy techniques have evolved from 3D conformal radiotherapy (3D-CRT) to intensity modulated radiotherapy (IMRT) where boost fields are delivered either sequentially (IMRTseq) or with a simultaneous integrated boost (IMRT+SIB). Our goal was to compare the outcomes of patients treated with IMRT+SIB to traditional standards. METHODS: We analyzed the efficacy and toxicity of patients treated with concurrent chemoradiation using 3D-CRT, IMRTseq or IMRT+SIB. Between 1993 and 2012, 379 patients with non-metastatic Stage III-IV head and neck squamous cell cancer were treated with concurrent chemoradiation using 3D-CRT (n = 125), IMRTseq (n = 120) and IMRT+SIB (n = 134). RESULTS: Patients treated with any technique had similar rates of 2y local control, 2y regional control, 2y progression free survival and 2y overall survival. Patients treated with IMRT+SIB had lower rates acute toxicity according to Grade 3 or greater mucositis (3D-CRT: 44.0% vs. IMRTseq: 36.7% vs. IMRT+SIB: 22.4%; P<.0001), dermatitis (3D-CRT: 44.0% vs. IMRTseq: 20.0% vs. IMRT+SIB: 7.5%; P<.0001) and feeding tube placement during radiotherapy (3D-CRT: 80.0% vs. IMRTseq: 50.8% vs. IMRT+SIB: 44.0%; P<.0001) as well as late toxicity as measured by feeding tube use (P<.0001) and tracheostomy use (P<.0001). On multivariate analysis, IMRT+SIB predicted for less mucositis, dermatitis and feeding tube use compared to 3D-CRT and for less dermatitis compared to IMRTseq. CONCLUSIONS: Compared to 3D-CRT and IMRTseq, IMRT+SIB provided similar outcomes and potentially less toxicity indicating it is a feasible technique for chemoradiation in locally advanced head and neck cancer.
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spelling pubmed-39798912014-04-11 Comparison of 3D Confromal Radiotherapy and Intensity Modulated Radiotherapy with or without Simultaneous Integrated Boost during Concurrent Chemoradiation for Locally Advanced Head and Neck Cancers Spiotto, Michael T. Weichselbaum, Ralph R. PLoS One Research Article OBJECTIVE: Radiotherapy techniques have evolved from 3D conformal radiotherapy (3D-CRT) to intensity modulated radiotherapy (IMRT) where boost fields are delivered either sequentially (IMRTseq) or with a simultaneous integrated boost (IMRT+SIB). Our goal was to compare the outcomes of patients treated with IMRT+SIB to traditional standards. METHODS: We analyzed the efficacy and toxicity of patients treated with concurrent chemoradiation using 3D-CRT, IMRTseq or IMRT+SIB. Between 1993 and 2012, 379 patients with non-metastatic Stage III-IV head and neck squamous cell cancer were treated with concurrent chemoradiation using 3D-CRT (n = 125), IMRTseq (n = 120) and IMRT+SIB (n = 134). RESULTS: Patients treated with any technique had similar rates of 2y local control, 2y regional control, 2y progression free survival and 2y overall survival. Patients treated with IMRT+SIB had lower rates acute toxicity according to Grade 3 or greater mucositis (3D-CRT: 44.0% vs. IMRTseq: 36.7% vs. IMRT+SIB: 22.4%; P<.0001), dermatitis (3D-CRT: 44.0% vs. IMRTseq: 20.0% vs. IMRT+SIB: 7.5%; P<.0001) and feeding tube placement during radiotherapy (3D-CRT: 80.0% vs. IMRTseq: 50.8% vs. IMRT+SIB: 44.0%; P<.0001) as well as late toxicity as measured by feeding tube use (P<.0001) and tracheostomy use (P<.0001). On multivariate analysis, IMRT+SIB predicted for less mucositis, dermatitis and feeding tube use compared to 3D-CRT and for less dermatitis compared to IMRTseq. CONCLUSIONS: Compared to 3D-CRT and IMRTseq, IMRT+SIB provided similar outcomes and potentially less toxicity indicating it is a feasible technique for chemoradiation in locally advanced head and neck cancer. Public Library of Science 2014-04-08 /pmc/articles/PMC3979891/ /pubmed/24714187 http://dx.doi.org/10.1371/journal.pone.0094456 Text en © 2014 Spiotto, Weichselbaum http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Spiotto, Michael T.
Weichselbaum, Ralph R.
Comparison of 3D Confromal Radiotherapy and Intensity Modulated Radiotherapy with or without Simultaneous Integrated Boost during Concurrent Chemoradiation for Locally Advanced Head and Neck Cancers
title Comparison of 3D Confromal Radiotherapy and Intensity Modulated Radiotherapy with or without Simultaneous Integrated Boost during Concurrent Chemoradiation for Locally Advanced Head and Neck Cancers
title_full Comparison of 3D Confromal Radiotherapy and Intensity Modulated Radiotherapy with or without Simultaneous Integrated Boost during Concurrent Chemoradiation for Locally Advanced Head and Neck Cancers
title_fullStr Comparison of 3D Confromal Radiotherapy and Intensity Modulated Radiotherapy with or without Simultaneous Integrated Boost during Concurrent Chemoradiation for Locally Advanced Head and Neck Cancers
title_full_unstemmed Comparison of 3D Confromal Radiotherapy and Intensity Modulated Radiotherapy with or without Simultaneous Integrated Boost during Concurrent Chemoradiation for Locally Advanced Head and Neck Cancers
title_short Comparison of 3D Confromal Radiotherapy and Intensity Modulated Radiotherapy with or without Simultaneous Integrated Boost during Concurrent Chemoradiation for Locally Advanced Head and Neck Cancers
title_sort comparison of 3d confromal radiotherapy and intensity modulated radiotherapy with or without simultaneous integrated boost during concurrent chemoradiation for locally advanced head and neck cancers
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3979891/
https://www.ncbi.nlm.nih.gov/pubmed/24714187
http://dx.doi.org/10.1371/journal.pone.0094456
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