Outcome and toxicity of intensity-modulated radiotherapy with simultaneous integrated boost in patients with pharyngo-laryngeal cancer

• A. Fondevilla Soler ^[2] ; I. Azinovic ^[3] ; M. Alcaraz ^[4] ; E. Rivin del Campo ^[1] ; J. M. Praena-Fernandez ^[5] ; M. J. Belmonte González ^[3] ; M. A. Samaniego Conde ^[3] ; A. García Fernández ^[3] ; J. LLópez-Guerra ^[5]
  1. [1] Tenon Hospital

     Tenon Hospital

     París, Francia

     
  2. [2] GenesisCareMurciaSpain
  3. [3] GenesisCareMadridSpain
  4. [4] University of MurciaMurciaSpain
  5. [5] University Hospital Virgen del RocioSevilleSpain

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• Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 21, Nº. 7, 2019, págs. 881-890
• Idioma: inglés
• Texto completo no disponible (Saber más ...)
• Dialnet Métricas: 1 Cita
• Resumen

  • Purpose The present work aims at evaluating intensity-modulated radiation therapy with simultaneous integrated boost (IMRT-SIB) in squamous cell carcinomas (SCC) of the larynx and hypopharynx.

    Methods/patients We performed a single institutional retrospective analysis on 116 pharyngo (29%)-laryngeal (71%) SCC patients (93% male) treated with IMRT-SIB to 66–69.96 Gy in 33 fractions between 2008 and 2016. Those who underwent surgery (54%) received adjuvant radiation of 66 Gy at 2 Gy/fraction to the surgical bed. 16 patients (14%) were treated for a local recurrence after prior surgery. High-risk lymph node regions received 59.4 Gy at 1.8 Gy/fraction and low risk regions 54.12 Gy at 1.64 Gy/fraction. The median age was 60 years and 95% of patients had an ECOG performance status 0–2. Most had advanced stage disease (III 22%, IV 74%). Chemotherapy was delivered in 74% of cases.

    Results Median follow-up was 32 months. Two and three-year overall survival for all patients was 87% and 82%, respectively. There were 28 (24%) locoregional recurrences and 19 (16%) distant failures. Grade 3 mucositis, dermatitis, and xerostomy were observed in 12%, 10%, and 3%, respectively. A longer IMRT-SIB overall treatment time was associated with a higher risk of mortality (HR 1.09, CI 1.01–1.17, P = 0.02). Postoperative IMRT-SIB associated with a significantly lower risk of any recurrence (HR 0.34, CI 0.18–0.64, P = 0.001) and higher local control (HR 0.06, CI 0.01–0.24, P < 0.01). Additionally, it associated with a lower risk of mucositis (P = 0.029) compared with definitive radio (chemo) therapy.

    Conclusions IMRT-SIB is a safe and feasible radiation treatment technique for pharyngo-laryngeal SCC patients with a tolerable acute toxicity profile.