1. Intensity-modulated radiotherapy in the treatment of oropharyngeal cancer: an update of the Memorial Sloan-Kettering Cancer Center experience.
- Author
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Setton J, Caria N, Romanyshyn J, Koutcher L, Wolden SL, Zelefsky MJ, Rowan N, Sherman EJ, Fury MG, Pfister DG, Wong RJ, Shah JP, Kraus DH, Shi W, Zhang Z, Schupak KD, Gelblum DY, Rao SD, and Lee NY
- Subjects
- Adult, Aged, Aged, 80 and over, Analysis of Variance, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Cancer Care Facilities, Deglutition Disorders epidemiology, Female, Follow-Up Studies, Humans, Incidence, Male, Middle Aged, Neoplasm Staging, New York City, Oropharyngeal Neoplasms drug therapy, Oropharyngeal Neoplasms mortality, Oropharyngeal Neoplasms pathology, Palatal Neoplasms drug therapy, Palatal Neoplasms mortality, Palatal Neoplasms pathology, Palatal Neoplasms radiotherapy, Palate, Soft, Pharyngeal Neoplasms drug therapy, Pharyngeal Neoplasms mortality, Pharyngeal Neoplasms pathology, Pharyngeal Neoplasms radiotherapy, Radiotherapy Dosage, Tongue Neoplasms drug therapy, Tongue Neoplasms mortality, Tongue Neoplasms pathology, Tongue Neoplasms radiotherapy, Tonsillar Neoplasms drug therapy, Tonsillar Neoplasms mortality, Tonsillar Neoplasms pathology, Tonsillar Neoplasms radiotherapy, Treatment Failure, Xerostomia epidemiology, Oropharyngeal Neoplasms radiotherapy, Radiotherapy, Intensity-Modulated
- Abstract
Purpose: To update the Memorial Sloan-Kettering Cancer Center's experience with intensity-modulated radiotherapy (IMRT) in the treatment of oropharyngeal cancer (OPC)., Methods and Materials: Between September 1998 and April 2009, 442 patients with histologically confirmed OPC underwent IMRT at our center. There were 379 men and 63 women with a median age of 57 years (range, 27-91). The disease was Stage I in 2%, Stage II in 4%, Stage III in 21%, and Stage IV in 73% of patients. The primary tumor subsite was tonsil in 50%, base of tongue in 46%, pharyngeal wall in 3%, and soft palate in 2%. The median prescription dose to the planning target volume of the gross tumor was 70 Gy for definitive (n = 412) cases and 66 Gy for postoperative cases (n = 30). A total 404 patients (91%) received chemotherapy, including 389 (88%) who received concurrent chemotherapy, the majority of which was platinum-based., Results: Median follow-up among surviving patients was 36.8 months (range, 3-135). The 3-year cumulative incidence of local failure, regional failure, and distant metastasis was 5.4%, 5.6%, and 12.5%, respectively. The 3-year OS rate was 84.9%. The incidence of late dysphagia and late xerostomia ≥Grade 2 was 11% and 29%, respectively., Conclusions: Our results confirm the feasibility of IMRT in achieving excellent locoregional control and low rates of xerostomia. According to our knowledge, this study is the largest report of patients treated with IMRT for OPC., (Copyright © 2012 Elsevier Inc. All rights reserved.)
- Published
- 2012
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