Abstract
BACKGROUND. Treatment outcomes for stage III and IV oropharyngeal carcinoma treated with intensity-modulated radiotherapy (IMRT) and concurrent chemotherapy without prior surgical resection were reviewed. METHODS. Between April 2000 and September 2004, 71 patients underwent IMRT concurrent with chemotherapy without prior surgical resection for stage III and IV oropharyngeal carcinoma. Chemotherapy was platinum based. The gross tumor volume (GTV) received 70 Gy in 2.12 Gy per fraction. The high-risk clinical tumor volume (CTV) received 59.4 Gy in 1.80 Gy per fraction, and the low-risk CTV received 54 Gy in 1.64 Gy per fraction. RESULTS. With a median follow-up of 33 months, the 3-year local, regional, and locoregional progression-free probabilities were 94%, 94%, and 90%, respectively. The 3-year overall survival estimate was 83%. Locoregional failures occurred in the GTV in 7 patients. Acute grade 3 or 4 toxicity developed in 35 patients. A feeding gastrostomy was placed in 25 patients. Late xerostomia was grade 0 in 16 patients, grade 1 in 31 patients, and grade 2 in 24 patients at last follow-up. No patients experienced grade 3 or 4 late toxicity, except for 1 who developed osteoradionecrosis of the mandible. CONCLUSIONS. Excellent local and regional control was achieved with IMRT and concurrent chemotherapy without prior surgical resection in the treatment of stage III and IV oropharyngeal carcinoma. Significant sparing of the parotid glands and other critical normal tissues was possible using IMRT with moderate acute toxicities and minimal severe late effects.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 497-507 |
| Number of pages | 11 |
| Journal | Cancer |
| Volume | 113 |
| Issue number | 3 |
| DOIs | |
| State | Published - Aug 1 2008 |
| Externally published | Yes |
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Keywords
- Chemotherapy
- Cisplatin
- Head and neck cancer
- Intensity-modulated radiotherapy
- Locally advanced
- Oropharyngeal carcinoma
ASJC Scopus subject areas
- Cancer Research
- Oncology
Cite this
Intensity-modulated chemoradiation for treatment of stage III and IV oropharyngeal carcinoma : The University of California-San Francisco experience. / Huang, Kim; Xia, Ping; Chuang, Cynthia; Weinberg, Vivian; Glastonbury, Christine M.; Eisele, David W; Lee, Nancy Y.; Yom, Sue S.; Phillips, Theodore L.; Quivey, Jeanne M.
In: Cancer, Vol. 113, No. 3, 01.08.2008, p. 497-507.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Intensity-modulated chemoradiation for treatment of stage III and IV oropharyngeal carcinoma
T2 - The University of California-San Francisco experience
AU - Huang, Kim
AU - Xia, Ping
AU - Chuang, Cynthia
AU - Weinberg, Vivian
AU - Glastonbury, Christine M.
AU - Eisele, David W
AU - Lee, Nancy Y.
AU - Yom, Sue S.
AU - Phillips, Theodore L.
AU - Quivey, Jeanne M.
PY - 2008/8/1
Y1 - 2008/8/1
N2 - BACKGROUND. Treatment outcomes for stage III and IV oropharyngeal carcinoma treated with intensity-modulated radiotherapy (IMRT) and concurrent chemotherapy without prior surgical resection were reviewed. METHODS. Between April 2000 and September 2004, 71 patients underwent IMRT concurrent with chemotherapy without prior surgical resection for stage III and IV oropharyngeal carcinoma. Chemotherapy was platinum based. The gross tumor volume (GTV) received 70 Gy in 2.12 Gy per fraction. The high-risk clinical tumor volume (CTV) received 59.4 Gy in 1.80 Gy per fraction, and the low-risk CTV received 54 Gy in 1.64 Gy per fraction. RESULTS. With a median follow-up of 33 months, the 3-year local, regional, and locoregional progression-free probabilities were 94%, 94%, and 90%, respectively. The 3-year overall survival estimate was 83%. Locoregional failures occurred in the GTV in 7 patients. Acute grade 3 or 4 toxicity developed in 35 patients. A feeding gastrostomy was placed in 25 patients. Late xerostomia was grade 0 in 16 patients, grade 1 in 31 patients, and grade 2 in 24 patients at last follow-up. No patients experienced grade 3 or 4 late toxicity, except for 1 who developed osteoradionecrosis of the mandible. CONCLUSIONS. Excellent local and regional control was achieved with IMRT and concurrent chemotherapy without prior surgical resection in the treatment of stage III and IV oropharyngeal carcinoma. Significant sparing of the parotid glands and other critical normal tissues was possible using IMRT with moderate acute toxicities and minimal severe late effects.
AB - BACKGROUND. Treatment outcomes for stage III and IV oropharyngeal carcinoma treated with intensity-modulated radiotherapy (IMRT) and concurrent chemotherapy without prior surgical resection were reviewed. METHODS. Between April 2000 and September 2004, 71 patients underwent IMRT concurrent with chemotherapy without prior surgical resection for stage III and IV oropharyngeal carcinoma. Chemotherapy was platinum based. The gross tumor volume (GTV) received 70 Gy in 2.12 Gy per fraction. The high-risk clinical tumor volume (CTV) received 59.4 Gy in 1.80 Gy per fraction, and the low-risk CTV received 54 Gy in 1.64 Gy per fraction. RESULTS. With a median follow-up of 33 months, the 3-year local, regional, and locoregional progression-free probabilities were 94%, 94%, and 90%, respectively. The 3-year overall survival estimate was 83%. Locoregional failures occurred in the GTV in 7 patients. Acute grade 3 or 4 toxicity developed in 35 patients. A feeding gastrostomy was placed in 25 patients. Late xerostomia was grade 0 in 16 patients, grade 1 in 31 patients, and grade 2 in 24 patients at last follow-up. No patients experienced grade 3 or 4 late toxicity, except for 1 who developed osteoradionecrosis of the mandible. CONCLUSIONS. Excellent local and regional control was achieved with IMRT and concurrent chemotherapy without prior surgical resection in the treatment of stage III and IV oropharyngeal carcinoma. Significant sparing of the parotid glands and other critical normal tissues was possible using IMRT with moderate acute toxicities and minimal severe late effects.
KW - Chemotherapy
KW - Cisplatin
KW - Head and neck cancer
KW - Intensity-modulated radiotherapy
KW - Locally advanced
KW - Oropharyngeal carcinoma
UR - http://www.scopus.com/inward/record.url?scp=49049093209&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=49049093209&partnerID=8YFLogxK
U2 - 10.1002/cncr.23578
DO - 10.1002/cncr.23578
M3 - Article
VL - 113
SP - 497
EP - 507
JO - Cancer
JF - Cancer
SN - 0008-543X
IS - 3
ER -