Prospective randomized controlled trial to compare 3‐dimensional conformal radiotherapy to intensity‐modulated radiotherapy in head and neck squamous cell carcinoma: Long‐term results

• DOI: 10.1002/hed.24263
• Publication Date: 2015-11-11T14:44:44Z
• Authors: Sarbani Ghosh–Laskar; Prahlad H. Yathiraj; Debnarayana Dutta; Venkatesh Rangarajan; Nilendu Purandare; Tejpal Gupta; Ashwini Budrukkar; Vedang Murthy; Sadhana Kannan; Jai Prakash Agarwal
• Keywords: Adult; Male; Middle Aged; Xerostomia; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Head and Neck Neoplasms; Carcinoma, Squamous Cell; Humans; Female; Prospective Studies; Radiotherapy, Intensity-Modulated; Radiotherapy, Conformal; Aged

AbstractBackgroundGrade ≥2 acute xerostomia between 3D conformal radiotherapy (RT) and intensity‐modulated radiotherapy (IMRT) was evaluated in patients with head and neck squamous cell carcinomas (HNSCCs) treated radically.MethodsBetween 2005 and 2007, 59 patients with HNSCC (T1–3, N0–2b) were randomized to IMRT or 3D‐RT. On RT, weekly xerostomia, dysphagia, dermatitis, and mucositis were graded by Radiation Therapy Oncology Group (RTOG) acute toxicity criteria. Patients underwent examination under anesthesia, positron emission tomography (PET)‐CT, and toxicity assessments per protocol (NCT00652613) thereafter.ResultsIncidence of grade ≥2 xerostomia at 8 weeks posttreatment was significantly lower with IMRT compared with 3D conformal RT (24% vs 53%; p = .024). At subsequent follow‐up, significantly fewer patients receiving IMRT had grade ≥2 xerostomia. Long‐term weight loss was higher in patients in the 3D conformal RT arm compared to IMRT (50% vs 21%; p = .038). Disease‐related outcomes between arms (median follow‐up, 70 months) were similar.ConclusionIMRT significantly reduces incidence of acute and late grade ≥2 xerostomia in patients with HNSCC. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1481–E1487, 2016