Intensity-Modulated Radiotherapy in the Treatment of Oropharyngeal Cancer: An Update of the Memorial Sloan-Kettering Cancer Center Experience

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• 作者：Jeremy Setton ; B.A.^&lowast ; ; ¹ ; Nicola Caria ; M.D.^&lowast ; ; ¹ ; Jonathan Romanyshyn ; M.D.^&lowast ; ; Lawrence Koutcher ; M.D.^&lowast ; ; Suzanne L. Wolden ; M.D.^&lowast ; ; Michael J. Zelefsky ; M.D.^&lowast ; ; Nicholas Rowan ; B.A.^&lowast ; ; Eric J. Sherman ; M.D.^&dagger ; ; Matthew G. Fury ; M.D. ; Ph.D.^&dagger ; ; David G. Pfister ; M.D.^&dagger ; ; Richard J. Wong ; M.D.^&Dagger ; ; Jatin P. Shah ; M.D.^&Dagger ; ; Dennis H. Kraus ; M.D.^&Dagger ; ; Weiji Shi ; M.S.^§ ; ; Zhigang Zhang ; Ph.D.^§ ; ; Karen D. Schupak ; M.D.^&lowast ; ; Daphna Y. Gelblum ; M.D.^&lowast ; ; Shyam D. Rao ; M.D. ; Ph.D.^&lowast ; ; Nancy Y. Lee ; M.D.^&lowast ; ; ^{Leen2@mskcc.org}
• 关键词：Oropharyngeal cancer ; IMRT ; Head-and-neck cancer ; Xerostomia ; Dysphagia
• 刊名：International Journal of Radiation Oncology*Biology*Physics
• 出版年：2012
• 出版时间：1 January 2012
• 年：2012
• 卷：82
• 期：1
• 页码：291-298
• 全文大小：169 K

文摘

| Figures/TablesFigures/Tables | ReferencesReferences<h4 class=""h4"">Purposeh4>To update the Memorial Sloan-Kettering Cancer Center¡¯s experience with intensity-modulated radiotherapy (IMRT) in the treatment of oropharyngeal cancer (OPC).<h4 class=""h4"">Methods and Materialsh4>

Between September 1998 and April 2009, 442 patients with histologically confirmed OPC underwent IMRT at our center. There were 379 men and 63 women with a median age of 57 years (range, 27?1). The disease was Stage I in 2 % , Stage II in 4 % , Stage III in 21 % , and Stage IV in 73 % of patients. The primary tumor subsite was tonsil in 50 % , base of tongue in 46 % , pharyngeal wall in 3 % , and soft palate in 2 % . The median prescription dose to the planning target volume of the gross tumor was 70 Gy for definitive (n = 412) cases and 66 Gy for postoperative cases (n = 30). A total 404 patients (91 % ) received chemotherapy, including 389 (88 % ) who received concurrent chemotherapy, the majority of which was platinum-based.<h4 class=""h4"">Resultsh4>

Median follow-up among surviving patients was 36.8 months (range, 3?35). The 3-year cumulative incidence of local failure, regional failure, and distant metastasis was 5.4 % , 5.6 % , and 12.5 % , respectively. The 3-year OS rate was 84.9 % . The incidence of late dysphagia and late xerostomia ¡ÝGrade 2 was 11 % and 29 % , respectively.<h4 class=""h4"">Conclusionsh4>

Our results confirm the feasibility of IMRT in achieving excellent locoregional control and low rates of xerostomia. According to our knowledge, this study is the largest report of patients treated with IMRT for OPC.