If this is not your name, click here.
| | If this is not your name, click here. | | |
| | Contact Us | Order Now | Journals | Bookstore | Register a colleague | | |
| |  Simultaneous Integrated Boost Intensity-Modulated Radiation Therapy Effective in Patients With Advanced Head and Neck Cancers: Presented at IAOO By Louise Gagnon TORONTO -- July 20, 2009 -- Stratifying patients according to their disease status before they receive simultaneous integrated boost (SIB) intensity-modulated radiation therapy (IMRT) will permit judicious use of the technology in a setting where resources are scarce, suggest results of a study out of India presented here at the 2nd World Congress of the International Academy of Oral Oncology (IAOO). “We wanted to see if it is feasible to administer this treatment and what the results would be,” explained the study’s lead author Sushmita Ghoshal, MD, Department of Radiotherapy and Oncology, Post Graduate Institute of Medical Education and Research, Chandigarh, India. In an interview at a July 10 poster session, Dr. Ghoshal noted that 31 patients (mean age, 55) with head and neck cancers were treated with SIB-IMRT on an outpatient basis. The primary site was the oropharynx in 23 patients, laryngopharynx in 6 patients, and oral tongue in 2 patients. The complete dose to the gross tumour volume ranged between 66 to 72 Gy. Investigators assessed tumour response at 3 months after completion of therapy. The mean Karnofsky Performance Status (KPS) score was 80, and 23 patients were addicted to tobacco. The vast majority of patients (29) were diagnosed with either stage III or IVA cancer. At 3 months follow-up after treatment was completed, 30 of the 31 patients were free of disease. Mean disease-free survival at 2 years was 93.55 months. “We think that it is a very encouraging result,” said Dr. Ghoshal. One of the advantages of the therapy is that it spares at least 1 of the parotid glands, so that patients still have salivary function. “The beauty of the treatment is that while we are administering radiation to the tumour-bearing area, we are able to spare surrounding normal tissues,” she explained. “We are able to spare at least 1 of the parotid glands. In this way, the patient has a better quality of life.” Side effects that occurred with the treatment included mucositis, dermatitis, as well as pain and dysphagia during therapy. Analgesics were administered to 70% of patients to treat adverse events during therapy. After a median follow up of 21 months, only 2 patients had returned for treatment. Dr. Ghoshal explained that radiation oncologists deliver the specialised therapy to patients who have a higher KPS score to ensure they will be able to tolerate therapy and will respond to it. “We have to select patients who are fit for this and are in better general condition,” she said. “We consider their socio-economic conditions and if they are getting adequate nutrition. We would choose patients who have a KPS score of 70 or more.” The therapy, however, is typically not reserved for patients with lesser stage cancers. “There isn’t a point to using specialised treatment for less extensive disease,” said Dr. Ghoshal. The study was independently conducted. [Presentation title: IMRT With Simultaneous Integrated Boost in Head and Neck Carcinomas - A Preliminary Analysis. Abstract P2.106]
|
