Intensity-modulated versus conventional radiation therapy for oropharyngeal carcinoma: long-term dysphagia and tumor control outcomes.

Head & Neck Pub Date : 2014-04-01 Epub Date: 2013-06-01 DOI:10.1002/hed.23319

Sean M McBride, Ron J Parambi, Joanne W Jang, Tessa Goldsmith, Paul M Busse, Annie W Chan

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引用次数: 42

Abstract

Background: 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.

Methods: 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.

Results: Patients treated with IMRT had lower rates of xerostomia (p = .01) and shorter duration of gastrostomy-tube dependence (p < .0001), but increased risk of cervical esophageal stricture (p = .03). The overall rates of late dysphagia were not different between the 2 groups (p = .40). In multivariate analysis, IMRT was a significant predictor of decreased disease-specific mortality (hazard ratio [HR] = 0.24; p = .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; p = .08).

Conclusion: The incidence of late dysphagia is similar in IMRT and CRT, but the mechanism of dysphagia is different.

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口咽癌的调强放疗与常规放疗:长期吞咽困难和肿瘤控制结果。

背景:本研究的目的是确定调强放疗(IMRT)与常规放疗(CRT)治疗口咽癌患者的相对临床益处。方法:我们比较了132例在人乳头瘤病毒(HPV)时代接受终期放化疗的III期至IVA/B期口咽癌患者的肿瘤控制和毒性结果。结果:IMRT患者的口干率较低(p = 0.01)，胃造口管依赖时间较短(p < 0.0001)，但颈食管狭窄的风险增加(p = 0.03)。两组患者晚期吞咽困难的总体发生率无统计学差异(p = 0.40)。在多变量分析中，IMRT是降低疾病特异性死亡率的显著预测因子(危险比[HR] = 0.24;p = .03)。在调整T分类后，IMRT的使用与局部区域失败的显著降低趋势相关(HR = 0.17;P = .08)。结论:IMRT组与CRT组晚期吞咽困难发生率相似，但吞咽困难发生机制不同。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Head & Neck

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