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IMRT using simultaneously integrated boost (SIB) in head and neck cancer patients
G Studer1, P U Huguenin, J B Davis
1Department of Radiation Oncology, University Hospital, Zurich, Switzerland. gabriela.studer@usz.ch
Radiation Oncology (London, England)
|May 26, 2006
Summary
Intensity modulated radiation therapy (IMRT) with simultaneously integrated boost (SIB-IMRT) shows high effectiveness and safety for head and neck cancer (HNC). However, SIB-IMRT at 2.2 Gy per session is not recommended for large tumors involving laryngeal structures.
Area of Science:
- Radiation Oncology
- Head and Neck Cancer Treatment
- Clinical Research
Background:
- Intensity modulated radiation therapy (IMRT) shows promise in head and neck cancer (HNC), maintaining tumor control and improving salivary function.
- Limited data exists on normal tissue response with simultaneously integrated boost (SIB-IMRT) in HNC.
Purpose of the Study:
- To evaluate tumor response in HNC patients treated with SIB-IMRT.
- To assess tissue tolerance following different SIB-IMRT schedules.
Main Methods:
- Retrospective analysis of 115 HNC patients treated with curative intent SIB-IMRT between 2002-2004.
- SIB schedules included 2.0, 2.11, or 2.2 Gy per session, with total doses ranging from 60-70 Gy.
- Concomitant chemotherapy was administered in 78% of patients.
Main Results:
- At a median follow-up of 18 months, 77% of patients were alive with no evidence of disease.
- Actuarial 2-year disease-free survival rates were 77% (local), 87% (nodal), and 78% (distant).
- Low rates of acute reactions (mild to moderate) and late toxicity (6% grade 3/4) were observed, with two grade 4 toxicities (dysphagia, laryngeal fibrosis) linked to the 2.2 Gy/session schedule.
Conclusions:
- SIB-IMRT is effective and safe for HNC, demonstrating good tumor control and acceptable toxicity.
- The SIB schedule of 2.2 Gy per session is not advised for large tumors involving the larynx due to increased toxicity risk.