PreprintArticleVersion 1Preserved in Portico This version is not peer-reviewed
Moderately Hypofractionated Intensity Modulated Radiotherapy (IMRT) With a Simultaneous Integrated Boost (SIB) for Locally Advanced Head and Cancer – Do Modern Techniques Held Their Promise?
Version 1
: Received: 3 March 2021 / Approved: 4 March 2021 / Online: 4 March 2021 (16:10:05 CET)
How to cite:
Wichmann, J.; Durisin, M.; Hermann, R.M.; Merten, R.; Christiansen, H. Moderately Hypofractionated Intensity Modulated Radiotherapy (IMRT) With a Simultaneous Integrated Boost (SIB) for Locally Advanced Head and Cancer – Do Modern Techniques Held Their Promise?. Preprints2021, 2021030169. https://doi.org/10.20944/preprints202103.0169.v1
Wichmann, J.; Durisin, M.; Hermann, R.M.; Merten, R.; Christiansen, H. Moderately Hypofractionated Intensity Modulated Radiotherapy (IMRT) With a Simultaneous Integrated Boost (SIB) for Locally Advanced Head and Cancer – Do Modern Techniques Held Their Promise?. Preprints 2021, 2021030169. https://doi.org/10.20944/preprints202103.0169.v1
Wichmann, J.; Durisin, M.; Hermann, R.M.; Merten, R.; Christiansen, H. Moderately Hypofractionated Intensity Modulated Radiotherapy (IMRT) With a Simultaneous Integrated Boost (SIB) for Locally Advanced Head and Cancer – Do Modern Techniques Held Their Promise?. Preprints2021, 2021030169. https://doi.org/10.20944/preprints202103.0169.v1
APA Style
Wichmann, J., Durisin, M., Hermann, R.M., Merten, R., & Christiansen, H. (2021). Moderately Hypofractionated Intensity Modulated Radiotherapy (IMRT) With a Simultaneous Integrated Boost (SIB) for Locally Advanced Head and Cancer – Do Modern Techniques Held Their Promise?. Preprints. https://doi.org/10.20944/preprints202103.0169.v1
Chicago/Turabian Style
Wichmann, J., Roland Merten and Hans Christiansen. 2021 "Moderately Hypofractionated Intensity Modulated Radiotherapy (IMRT) With a Simultaneous Integrated Boost (SIB) for Locally Advanced Head and Cancer – Do Modern Techniques Held Their Promise?" Preprints. https://doi.org/10.20944/preprints202103.0169.v1
Abstract
Abstract: Background: Intensity modulated radiotherapy (IMRT) is still a standard of care for radiotherapy in locally advanced head and neck cancer (LA-HNSCC). Simultaneous integrated boost (SIB) and moderate hypofractionation offer an opportunity for individual dose painting and a reduction in overall treatment time. We present retrospective data on toxicity and locore-gional control of a patient cohort with LA-HNSCC treated with an IMRT-SIB concept in compar-ison to normofractionated 3D-conformal radiotherapy (3D-RT) after a long-term follow-up. Methods: Between 2012 and 2014, n=67 patients with HNSCC (stages III/IV without distant me-tastases) were treated with IMRT-SIB either definitively (single/total doses: 2.2/66 Gy, 2.08/62.4 Gy, 1.8/54 Gy in 30 fractions) or in the postoperative setting (2.08/62.4 Gy, 1.92/57.6 Gy, 1.8/54 Gy). These patients' clinical courses were matched (for sex, primary, and treatment concept) as part of a matched-pair analysis with patients treated before mid-2012 with normofractionated 3D-CRT (definitive: 2/50 Gy followed by a sequential boost up to 70 Gy; postoperative: 2/60-64 Gy). Chemotherapy/ immunotherapy was given concomitantly in both groups in the definitive situation (postoperative dependent on risk factors). The primary endpoints were acute and late toxicity; the secondary endpoint was locoregional control (LRC). Results: Sixty-seven patients treated with IMRT-SIB (n = 20 definitive, n = 47 adjuvant) were matched with 67 patients treated with 3D-RT. There were minor imbalances between the groups concerning nonmatching variables such as extracapsular extension (ECE) and chemotherapy in IMRT-SIB. Significantly less toxicity was found in favor of IMRT-SIB concerning dysphagia, ra-diation dermatitis, xerostomia, fibrosis, and lymphedema. After a median follow-up of 63 months, the median LRC was not reached (IMRT-SIB) vs. 69.5 months (3D-RT) (p=0.63). Conclusions: This moderately hypofractionated IMRT-SIB concept was shown to be feasible with less toxicity than conventional 3D-RT in this long-term follow-up observation.
Keywords
head and neck cancer; radiotherapy; IMRT; SIB; hypofractionation; toxicity
Subject
Medicine and Pharmacology, Immunology and Allergy
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
