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. 2007 Feb 1;67(2):438-44.
doi: 10.1016/j.ijrobp.2006.08.078. Epub 2006 Dec 4.

Disease-control rates following intensity-modulated radiation therapy for small primary oropharyngeal carcinoma

Adam S Garden  1 , William H Morrison, Pei-Fong Wong, Sam S Tung, David I Rosenthal, Lei Dong, Brian Mason, George H Perkins, K Kian Ang
Affiliations

Disease-control rates following intensity-modulated radiation therapy for small primary oropharyngeal carcinoma

Adam S Garden et al. Int J Radiat Oncol Biol Phys. .

Abstract

Background: The purpose of this study was to assess the ability of intensity-modulated radiation therapy (IMRT) to achieve favorable disease-control rates while minimizing parotid gland doses in patients treated for small primary tumors of the oropharynx.

Methods and materials: We retrospectively identified all patients who received IMRT as treatment for a small (<4 cm) primary tumor of the oropharynx between October 2000 and June 2002. Tumor characteristics, IMRT parameters, and patient outcomes were assessed.

Results: Fifty-one patients met the criteria for our study. All patients had treatment to gross disease with margin (CTV1), and all but 1 had treatment to the bilateral necks. The most common treatment schedule (39 patients) was a once-daily fractionation of prescribed doses of 63-66 Gy to the CTV1 and 54 Gy to subclinical sites, delivered in 30 fractions. Twenty-one patients (40%) had gastrostomy tubes placed during therapy; in 4 patients, the tube remained in place for more than 6 months after completion of IMRT. The median follow-up was 45 months. The 2-year actuarial locoregional control, recurrence-free, and overall survival rates were 94%, 88%, and 94%, respectively.

Conclusions: These preliminary data suggest that treatment with IMRT results in favorable locoregional control of small primary oropharynx tumors. IMRT did not appear to have a more favorable acute toxicity profile in this group with respect to the use of a feeding tube; however, the mean dose of radiation delivered to the parotid gland by IMRT was decreased, because 95% of patients had a mean dose of <30 Gy to at least one gland.

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Figures

Figure 1
Figure 1
Local-regional control associated with the use of IMRT in the treatment of small (< 4 cm) oropharyngeal tumors.
Figure 2
Figure 2
Recurrence free survival associated with the use of IMRT in the treatment of small (< 4 cm) oropharyngeal tumors.
Figure 3
Figure 3
Overall survival associated with the use of IMRT in the treatment of small (< 4 cm) oropharyngeal tumors.
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