Intensity-modulated radiotherapy followed by a brachytherapy boost for oropharyngeal cancer.

Abstract

BACKGROUND:

The purpose of this study was to reduce the incidence of radiation-induced toxicity in patients with early-stage oropharyngeal cancer, using highly conformal radiation techniques.

METHODS:

Between 2000 and 2011, 167 patients with T1-3N0-3 oropharyngeal cancer were treated with 46-Gy intensity-modulated radiation therapy (IMRT) followed by 22-Gy brachytherapy boost. In patients with node-positive disease, neck dissection was performed.

RESULTS:

The 5-year Kaplan-Meier estimates of local control, regional control, disease-free survival (DFS), and overall survival (OS) were 94%, 97%, 84%, and 72%, respectively. Feeding tubes were required in 26% of the patients. Grade ≥2 late xerostomia and dysphagia were 11% and 8%, respectively. Chemotherapy, tumor subsite, and bilateral neck irradiation correlate significantly with toxicity. Quality of life (QOL) scores deteriorate during and shortly after treatment but returned in all scales to baseline scores within 6 to 12 months, with the exception of xerostomia.

CONCLUSION:

Brachytherapy boost and neck dissection (in node-positive oropharyngeal cancer) after 46-Gy of IMRT resulted in excellent outcomes with low incidence of late toxicity and good QOL scores.

• Authors: Abrahim Al-Mamgani, Peter C Levendag, Peter van Rooij, Cees A Meeuwis, Aniel Sewnaik, David N Teguh
• Journal: Head & neck (Head Neck) Vol. 35 Issue 12 Pg. 1689-97 (Dec 2013) ISSN: 1097-0347 [Electronic] United States
• PMID: 23483648 (Publication Type: Journal Article)
• Copyright: Copyright © 2013 Wiley Periodicals, Inc., A Wiley Company.

Topics

• Adult
• Aged
• Aged, 80 and over
• Brachytherapy (adverse effects)
• Chemotherapy, Adjuvant
• Deglutition Disorders (etiology)
• Dermatitis (etiology)
• Enteral Nutrition
• Female
• Humans
• Kaplan-Meier Estimate
• Logistic Models
• Male
• Middle Aged
• Mucositis (etiology)
• Neck Dissection
• Neoplasm Metastasis
• Neoplasm Recurrence, Local (radiotherapy, surgery)
• Oropharyngeal Neoplasms (drug therapy, mortality, pathology, radiotherapy)
• Quality of Life
• Radiotherapy Dosage
• Radiotherapy, Intensity-Modulated (adverse effects)
• Xerostomia (etiology)