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• W2113140776 abstract "To compare the recurrence patterns after IMRT and conventional 2D radiotherapy (Convent.2DRT) in patients with oropharyngeal and hypopharyngeal cancer. One-hundred Patients with oropharyngeal or hypopharyngeal squamous cell carcinoma, were studied by a stage matched case control study. Fifty patients treated with inverse planning IMRT were compared with a control group of 50 patients treated with (Convent. 2DRT). Staging was done according to the AJCC 2002 staging manual. Patients in both groups received cisplatin based chemotherapy. Patients with base of tongue cancer were excluded due to the variability in defining the extent of recurrence on imaging. To define the site of relapse as being in the high or low dose PTV in the IMRT group, fusion of the diagnostic CT/MRI with the original planning CT scan was done. In Convent.2DRT, localization of recurrence site in relation to the high dose (≥60 Gy/30) or low dose(< 60 Gy/30) radiotherapy fields was done by extrapolating the anatomical landmarks on simulation check films to the diagnostic CT/MRI describing the site and 3D dimensions of the relapse .The total volume of the recurrent tumor (e.g., 1ry and lymph node) as seen on the CT/MRI was used to calculate the percentage of volume in high or low dose fields. The recurrence was considered in field if >95% of its volume is located in the initial high dose PTV/field, borderline if 20 to 95% is included, and marginal if <20% is included. The median age was 62 & 58 years, the median follow-up was 18 & 22.6 months, the median radiotherapy dose was 67.5 Gy & 66 Gy, the median overall survival was 70 & 50 months and the response rate was 93% & 89% in the IMRT group & control group, respectively. Six percent of patients recurred in the IMRT group versus 20% in the control. The sites of recurrence in IMRT were, locoregional in 66.66%& regional in 33.34% while in Convent.2DRT, they were local in 60%, locoregional in 30%& regional in 10%. In the IMRT group 100% of recurrences were in field while in the control, 80% were in field&20% were borderline. Half of the borderline recurrences was closely related to the occipital/skull base block & the other 1/2 was located nearly equal in both the high-dose and low-dose (posterior triangle) fields. The 5years locoregional control was 89.54% and 62.48% & the 5 years locoregional relapse free survival was 92% and 78.7% in the IMRT group and the control, respectively. This study shows that the recurrence pattern after IMRT was completely in field while that after conventional 2D radiotherapy was mainly in field but, with the possibility of marginal miss in the latter. Thus, IMRT (inverse planning) may prevent the risk of marginal miss that can be seen in conventional 2D radiotherapy due to overlapping a subclinical tumor during shielding a critical organ." @default.
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• W2113140776 date "2009-11-01" @default.
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• W2113140776 title "The Recurrence Patterns after IMRT and Conventional 2D Radiotherapy in Oropharyngeal and Hypopharyngeal Cancer" @default.
• W2113140776 doi "https://doi.org/10.1016/j.ijrobp.2009.07.932" @default.
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