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- W2973202319 abstract "To analyze whether the dosimetric superiority of Helical Tomotherapy (HT), RapidArc (RA), and SmartArc (SA) could be translated into clinical advantages in actual treatment of head and neck cancer. Newly diagnosed stage III to IVA laryngeal, hypopharyngeal, or oropharyngeal carcinoma patients, or refused operation, were randomized to receive HT, RA, or SA. The patients were treated with 2 cycles of cisplatin based induction chemotherapy, and 2-3 cycles concurrent chemotherapy. The prescription dose of pGTVp (the PTV of the primary GTV) and pGTVnd (the PTV of the metastatic lymph node) was 70 Gy, in 33 fractions. The high-risk subclinical CTV (CTV60) was 60Gy,and low-risk (CTV54) was 54Gy, respectively. Toxicities were evaluated according to CTCAE. Between January 2016 and December 2018, 90 eligible patients were randomized between HT(32 patients), RA(32 patients),and SA(26 patients).There was no significant difference in the incidences of acute skin reaction, xerostomia, and oral mucositis, respectively. The incidence of acute grade 3 pharynx mucositis was significant higher in SA group than HT and RA(34.6%, 6.2% and 9.4%, respectively, p=0.03), despite the homogeneity of pGTVp was significant better in SA plans (the mean homogeneity index was 1.04, 1.07 and 1.07, respectively, p=0.00). Only 4 patients were interrupted radiotherapy, one case was treated by HT but was the only patient received cetuximab. The others were associated with SA or RA (2 vs.1, respectively). There was no significant difference in mean dose of oral cavity and parotid glands. HT achieved significantly lowest maximum cord dose(the mean dose was 38.04Gy, 42.71Gy and 40.73Gy for HT, RA and SA, respectively, p=0.00). The acute toxicities of SmartArc were more serious in actual treatment, relatively. Helical Tomotherapy maybe more able to protect organs at risk. Certain IMRT may be more suitable for the treatment of head and neck cancer, but we need further analysis to long-term follow-up results." @default.
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- W2973202319 date "2019-09-01" @default.
- W2973202319 modified "2023-10-13" @default.
- W2973202319 title "Does Dosimetric Superiority of IMRT Translate into Clinical Advantages in Treatment of Head and Neck Cancer? A Prospective Randomized Phase II Study" @default.
- W2973202319 doi "https://doi.org/10.1016/j.ijrobp.2019.06.1703" @default.
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