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IMRT superior to 3D-CRT in oropharyngeal squamous cell carcinoma
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Patients with oropharyngeal squamous cell carcinoma treated with intensity-modulated radiation therapy experienced fewer grade ≥3 adverse events than those treated with conventional 3-D conformal radiation therapy, according to results of a retrospective review.
IMRT also was associated with significantly lower rates of percutaneous endoscopic gastrostomy tube dependence during and after therapy.
Few studies have compared treatment-related toxic and adverse effects of IMRT and conventional 3-D conformal radiation therapy (3D-CRT).
The study included 159 patients with treatment-naïve oropharyngeal primary tumors. Patients underwent definitive treatment with radiotherapy at the Hollings Cancer Center outpatient clinic at the Medical University of South Carolina between 2000 and 2009. Patients received doses of 70 Gy in 35 daily fractions.
Patients assigned to IMRT demonstrated a significantly lower rate of percutaneous endoscopic gastrostomy tube dependence 1 year after treatment. The benefit was observed in all patients (P=.02), as well as those with advanced T-stage (P=.01). Time to tube removal also was shorter in the IMRT group (P<.001).
Acute grade ≥3 adverse events
When compared with 3D-CRT, acute grade ≥3 toxic effects to the skin (P=.02) and mucous membranes (P<.001) were less common in the IMRT group.
Weight loss, treatment failure (HR=0.82; 95%CI, 0.47-1.41), OS (P=.45) and DFS (P=.26) were similar between treatment arms.
“Given the association between mucosal toxic effects, tube dependence and dysphagia, these findings may be an indication of improved swallowing outcomes with IMRT,” the researchers concluded.
Disclosure: The researchers report no relevant financial disclosures.
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