Intensity‐modulated versus conventional radiation therapy for oropharyngeal carcinoma: Long‐term dysphagia and tumor control outcomes. Issue 4 (1st June 2013)

• Record Type: Journal Article
• Authors: McBride, Sean M.; Parambi, Ron J.; Jang, Joanne W.; Goldsmith, Tessa; Busse, Paul M.; Chan, Annie W.
• Is Part Of: Head & neck. Volume 36:Issue 4(2014:Apr.)
• Page Start: 492
• Page End: 498
• Publication Date: 2013-06-01
• Subjects: Head -- Diseases -- Periodicals; Neck -- Diseases -- Periodicals; Head -- Periodicals; Neck -- Periodicals; Face -- Periodicals; 617.51059
• DOI: 10.1002/hed.23319
• Languages: English
• ISSNs: 1043-3074

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="hed23319-sec-0001" sec-type="section"> <title>Background</title> <p>The purpose of this study was to determine the relative clinical benefits of intensity‐modulated radiation therapy (IMRT) versus conventional radiotherapy (CRT) in the treatment of patients with oropharyngeal carcinoma.</p> </sec> <sec id="hed23319-sec-0002" sec-type="section"> <title>Methods</title> <p>We compared tumor control and toxicity outcomes in 132 patients with stage III to IVA/B oropharyngeal carcinoma treated with definitive chemoradiation in the human papillomavirus (HPV) era.</p> </sec> <sec id="hed23319-sec-0003" sec-type="section"> <title>Results</title> <p>Patients treated with IMRT had lower rates of xerostomia (<italic>p =</italic> .01) and shorter duration of gastrostomy‐tube dependence (<italic>p</italic> < .0001), but increased risk of cervical esophageal stricture (<italic>p</italic> = .03). The overall rates of late dysphagia were not different between the 2 groups (<italic>p</italic> = .40). In multivariate analysis, IMRT was a significant predictor of decreased disease‐specific mortality (hazard ratio [HR] = 0.24; <italic>p</italic> = .03) after adjustment for T‐category and active smoking. After adjustment for T classification, IMRT use was associated with a trend toward a significant decrease in locoregional failure (HR = 0.17; <italic>p</italic> = .08).</p> </sec> <sec id="hed23319-sec-0004" sec-type="section"> <title>Conclusion</title> <p>The incidence of late dysphagia is similar in IMRT and CRT, but the mechanism of dysphagia is different. © 2013 Wiley Periodicals, Inc. <italic>Head Neck</italic><bold>36</bold>: 492–498, 2014</p> </sec> </abstract>