Toxicities and Outcome of Intensity Modulated Radiotherapy Vs 2D Conformal Radiotherapy in Head and Neck Cancers
Journal Title: Indian Journal of Cancer Education and Research - Year 2017, Vol 5, Issue 2
Abstract
Aim: To compare toxicities and outcome in head and neck cancers patients treated with IMRT and 2D conformal radiotherapy along with concurrent chemotherapy. Materials and Methods: Patients presenting to the Department of Radiation oncology with head and neck squamous cell cancers TNM staging T14 N03 M0. Twenty patients of head and neck cancer and 20 undergoing conventional 2DConformal Radiotherapy alone served as controls were included in this study. Results: Most of these patients were found to be in highly advanced stage of disease with poor nutritional status and poor performance status (stage III and IVA) at the time of diagnosis. All the 40 patients received concurrent cisplatin chemotherapy. All the patients were examined and graded for mucositis, dysphagia, xerostomia, skin reactions and tumor response. This study was conducted to compare whether Simultaneous Integrated BoostIntensity Modulated Radiotherapy (SIBIMRT) could reduce radiotherapy induced acute mucositis, dysphagia, xerostomia and increase tumor response and tolerance to it in head and neck cancer patients compared to standard conventional Radiotherapy. IMRT may have had a role in reducing the incidence, delaying the onset & diminishing the severity of mucositis in some patients. However it did not completely prevent the occurrence of mucositis. Our study demonstrated that the IMRT may not reduce the incidence of dysphagia. It may be because of high dose per fraction in IMRT delivered to swallowing apparatus. IMRT reduced the incidence of xerostomia. Also the duration of xerostomia was decreased by IMRT. IMRT was also able to reduce the dose to parotids along with adequate coverage of planning target volume. Submandibular glands received less doses, particularly in hypopharyngeal and nasopharyngeal cancers. The contralateral parotid in all IMRT patients were within the tolerance dose of 26 Gy of mean dose. In few selected IMRT patients depending on the primary site, ipsilateral parotid were confined to their tolerance doses of 26 Gy of mean doses. Our study did not show any benefit for tumor response due to IMRT. However the incidence of recurrence is reduced due to IMRT. Conclusion: IMRT offers a safe, effective, reduction of normal tissue dose in head and neck cancer patients undergoing radiotherapy & was generally well tolerated. Hence we recommend using IMRT in head and neck cancer patients undergoing radiotherapy in order to reduce RT induced acute mucositis and xerostomia.
Authors and Affiliations
Nindra Armugram
Keywords
Related Articles
- EP ID EP460161
- DOI 10.21088/ijcer.2321.9815.5217.2
- Views 92
- Downloads 0
Hypoxia Inducible Factor-1 (HIF-1) and Cancer Progression: A Comprehensive Review
Hypoxia is characterized as a decrease oxygen levels in tissue, represents a fundamental pathophysiological condition in the microenvironment of solid tumors. The key component of hypoxia sensing in the cell is the hypox...
Nutritional Status Assessment and Its Correlation with Performance Status in Head & Neck Cancer Patients
ontext: Malnutrition among cancer patients is a frequent problem and has been observed in 40 and 80% patients. It is a more common problem in patients with head and neck cancer owing to the nutrition impact symptoms. It...
Testicular Tumors in Undescended Testes
Introduction: The failure of testicular descent or cryptorchidism is the most common defect in newborn boys. Cryptorchidism is an established risk factor for infertility and testicular germ cell tumors (TGCT). About 10%...
Limb Conservation for Tumors of the Proximal Humerus by Endoprosthetic Reconstruction: Our Experience
Introduction: Humerus is a common site for malignant tumors. Advances in adjuvant therapies and reconstructive methods provide salvage of the upper limb with improved outcomes. Materials and Methods: In our surgical on...
Response to Induction Chemotherapy Predicts Survival in AML: A Single Centre Experience from North India
Aim: The present study was carried out to analyze the various patient related (e.g. age, sex, performance status), disease related (white blood cell count, cytogenetic and molecular mutational status)and treatment relat...