Prospective randomized controlled trial to compare 3-dimensional conformal radiotherapy to intensity-modulated radiotherapy in head and neck squamous cell carcinoma: Long-term results

Background Grade ≥2 acute xerostomia between 3D conformal radiotherapy (RT) and intensity‐modulated radiotherapy (IMRT) was evaluated in patients with head and neck squamous cell carcinomas (HNSCCs) treated radically. Methods Between 2005 and 2007, 59 patients with HNSCC (T1–3, N0–2b) were randomize...

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Published in:Head & neck 2016-04, Vol.38 (S1), p.E1481-E1487
Main Authors: Ghosh-Laskar, Sarbani, Yathiraj, Prahlad H., Dutta, Debnarayana, Rangarajan, Venkatesh, Purandare, Nilendu, Gupta, Tejpal, Budrukkar, Ashwini, Murthy, Vedang, Kannan, Sadhana, Agarwal, Jai Prakash
Format: Article
Language:English
Subjects:
Adult
Aged
Carcinoma, Squamous Cell - radiotherapy
conformal radiotherapy
Female
head and neck cancer
Head and Neck Neoplasms - radiotherapy
Humans
intensity-modulated radiotherapy (IMRT)
Male
Middle Aged
Prospective Studies
Radiotherapy, Conformal
Radiotherapy, Intensity-Modulated
squamous cell carcinoma
Xerostomia - prevention & control
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Summary:Background Grade ≥2 acute xerostomia between 3D conformal radiotherapy (RT) and intensity‐modulated radiotherapy (IMRT) was evaluated in patients with head and neck squamous cell carcinomas (HNSCCs) treated radically. Methods Between 2005 and 2007, 59 patients with HNSCC (T1–3, N0–2b) were randomized to IMRT or 3D‐RT. On RT, weekly xerostomia, dysphagia, dermatitis, and mucositis were graded by Radiation Therapy Oncology Group (RTOG) acute toxicity criteria. Patients underwent examination under anesthesia, positron emission tomography (PET)‐CT, and toxicity assessments per protocol (NCT00652613) thereafter. Results Incidence of grade ≥2 xerostomia at 8 weeks posttreatment was significantly lower with IMRT compared with 3D conformal RT (24% vs 53%; p = .024). At subsequent follow‐up, significantly fewer patients receiving IMRT had grade ≥2 xerostomia. Long‐term weight loss was higher in patients in the 3D conformal RT arm compared to IMRT (50% vs 21%; p = .038). Disease‐related outcomes between arms (median follow‐up, 70 months) were similar. Conclusion IMRT significantly reduces incidence of acute and late grade ≥2 xerostomia in patients with HNSCC. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1481–E1487, 2016
ISSN:1043-3074
1097-0347
DOI:10.1002/hed.24263