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IMRT with concomitant boost versus conventional radiation in the setting of sequential chemoradiotherapy for oropharyngeal cancer

Published online by Cambridge University Press:  12 May 2014

Giovanni Franchin ,
Carlo Furlan ,
Emanuela Vaccher ,
Renato Talamini ,
Carlo Gobitti ,
Giuseppe Grando ,
Emilio Minatel ,
Andrea Dassie ,
Mauro Gaetano Trovò  and
Luigi Barzan
Giovanni Franchin
Affiliation:
Division of Radiotherapy, Centro di Riferimento Oncologico, IRCCS, Aviano, Italy
Carlo Furlan*
Affiliation:
Division of Radiotherapy, Centro di Riferimento Oncologico, IRCCS, Aviano, Italy
Emanuela Vaccher
Affiliation:
Division of Medical Oncology A, Centro di Riferimento Oncologico, IRCCS, Aviano, Italy
Renato Talamini
Affiliation:
Unit of Epidemiology and Biostatistics, Centro di Riferimento Oncologico, IRCCS, Aviano, Italy
Carlo Gobitti
Affiliation:
Division of Radiotherapy, Centro di Riferimento Oncologico, IRCCS, Aviano, Italy
Giuseppe Grando
Affiliation:
Head and Neck Division, General Hospital ‘S. Maria degli Angeli’, Pordenone, Italy
Emilio Minatel
Affiliation:
Division of Radiotherapy, Centro di Riferimento Oncologico, IRCCS, Aviano, Italy
Andrea Dassie
Affiliation:
Physics Department, Centro di Riferimento Oncologico, IRCCS, Aviano, Italy
Mauro Gaetano Trovò
Affiliation:
Division of Radiotherapy, Centro di Riferimento Oncologico, IRCCS, Aviano, Italy
Luigi Barzan
Affiliation:
Head and Neck Division, General Hospital ‘S. Maria degli Angeli’, Pordenone, Italy
*
Correspondence to: Carlo Furlan, Division of Radiotherapy, Centro di Riferimento Oncologico, IRCCS, Via Franco Gallini, 2, 33081 Aviano, Italy. Tel: +39-0434-659081; Email cfurlan@cro.it
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Abstract

Objectives

The aim of this study was to assess the efficacy of IMRT with concomitant boost simultaneous integrated boost-intensity modulated radiotherapy (SIB-IMRT) compared with conventional radiation in the setting of sequential chemoradiotherapy (induction chemoradiotherapy(ICRT)) for patients with advanced oropharynx cancer (OPC).

Materials and methods

A single-institutional retrospective review was conducted on 84 patients (conventional radiation, n = 36; SIB-IMRT, n = 48) with stage III and IV OPC, who underwent definitive ICRT from 2002 to 2012. The study endpoints included overall survival (OS) and locoregional control (LRC).

Results

The median follow-up of the matched cohorts resulted similar (30 months for 3D-radiation technique versus 37 months for IMRT), and baseline characteristics were generally balanced between the two groups. However, patients managed with conventional radiation were less likely to have positron emission tomography-computed tomography (PET-CT) for staging and to receive induction chemotherapy with TPF. A multivariate Cox proportional hazard model showed that OS and LRC were associated with several known prognostic factors, along with radiation modality (SIB-IMRT versus conventional radiation, hazard ratio 0·27, p = 0·004; hazard ratio 0·31, p = 0·006; for OS and LRC, respectively).

Conclusions

The adoption of SIB-IMRT versus conventional radiation may produce a clinical benefit in OS and LRC among patients receiving ICRT for advanced OPC.

Keywords

advanced oropharynx cancercombined modality therapyconcomitant boostIMRTsequential therapy
Type
Original Articles
Information
Journal of Radiotherapy in Practice , Volume 13 , Issue 4 , December 2014 , pp. 418 - 427
Copyright
Copyright © Cambridge University Press 2014 

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