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Moderately Hypofractionated Intensity-modulated Radiotherapy With a Simultaneous Integrated Boost for Locally Advanced Head and Neck Cancer – Do Modern Techniques Fulfil Their Promise?

Authors
  • WICHMANN, JÖRN1
  • DURISIN, MARTIN2
  • HERMANN, ROBERT MICHAEL1, 3
  • MERTEN, ROLAND1
  • CHRISTIANSEN, HANS1
  • 1 Department of Radiotherapy, Hannover Medical School, Hannover, Germany
  • 2 Department of Otorhinolaryngology, Hannover Medical School, Hannover, Germany
  • 3 Center for Radiotherapy, Westerstede, Germany
Type
Published Article
Journal
In Vivo
Publisher
International Institute of Anticancer Research
Publication Date
Sep 03, 2021
Volume
35
Issue
5
Pages
2801–2808
Identifiers
DOI: 10.21873/invivo.12566
PMID: 34410971
PMCID: PMC8408698
Source
PubMed Central
Keywords
Disciplines
  • Research Article
License
Unknown

Abstract

Background: Intensity-modulated radiotherapy (IMRT) with simultaneous integrated boost (SIB) and moderate hypofractionation offers an opportunity for defining individual doses and a reduction in overall treatment time in locally advanced head and neck cancer (HNSCC). We present retrospective data on toxicity and locoregional control of a patient cohort treated with an IMRT-SIB concept in comparison to normo-fractionated 3D-conformal radiotherapy (3D-RT). Patients and Methods: Between 2012 and 2014, 67 patients with HNSCC (stages III-IVB) were treated with IMRT-SIB either definitively or in the postoperative setting. These patients were matched with those of patients treated with normo-fractionated 3D-RT before mid-2012 and their clinical courses were compared. Chemotherapy or cetuximab was given concomitantly in both groups in the definitive situation (postoperatively, dependent on risk factors). Results: Significantly less toxicity was found in favor of IMRT-SIB concerning dysphagia, dermatitis, xerostomia, fibrosis, and lymphedema. After a median follow-up of 31 months (range=2-104 months), 3-year locoregional control was 73% for those treated with IMRT-SIB versus 78% for those treated with 3D-RT. Conclusion: This moderately hypofractionated IMRT-SIB concept was shown to be feasible, incurring less toxicity than conventional 3D-RT.

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