Effectiveness of tomotherapy <i>v</i>
 <i>s</i> linear accelerator image-guided intensity-modulated radiotherapy for localized pharyngeal cancer treated with definitive concurrent chemoradiotherapy: a Taiwanese population-based propensity score-matched analysis

Wang, Yao-Ching; Li, Chia‐Chin; Chien, Chun-Ru

doi:10.1259/bjr.20170947

Cited by 6 publications

(4 citation statements)

References 33 publications

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“…This study indicated that TOMO radiotherapy demonstrated very low toxicity and good outcomes in patients with NPC. Another study retrospectively compared the efficacy of TOMO and IMRT in the treatment of pharyngeal cancers and found no significant difference in the 5‐year OS (79% vs. 74%, P = 0.15) between the two techniques 13 . However, in the present retrospective study, 101 patients in the TOMO and IMRT groups had non‐nasopharyngeal cancer.…”

Section: Tomotherapycontrasting

confidence: 57%

Precision radiotherapy for nasopharyngeal carcinoma

Zhang,

Chen,

Yuan

2024

Precision Radiation Oncology

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Nasopharyngeal carcinoma(NPC) occurs frequently in Southern China, and radiotherapy is the main treatment method. At present, intensity‐modulated radiotherapy is widely used, which has improved efficacy in patients with NPC and reduced toxicity and side effects. Recently, helical tomography radiotherapy, proton radiotherapy, carbon particle radiotherapy, and other radiotherapy techniques have been used for the clinical treatment of NPC. Individualized nasopharyngeal cancer targets have also been explored. This paper reviews the research progress in radiotherapy techniques and target volume for NPC

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Section: Tomotherapycontrasting

confidence: 57%

Precision radiotherapy for nasopharyngeal carcinoma

Zhang,

Chen,

Yuan

2024

Precision Radiation Oncology

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“…The most crucial determinant of optimal therapy in advanced disease is the primary site—oral cavity malignancies are often most amenable to surgical resection, whereas pharyngeal malignancies are often best managed with primary radiotherapy. 9,10…”

Section: Introductionmentioning

confidence: 99%

“…The most crucial determinant of optimal therapy in advanced disease is the primary site-oral cavity malignancies are often most amenable to surgical resection, whereas pharyngeal malignancies are often best managed with primary radiotherapy. 9,10 The optimal regime in the elderly population remains in doubt due to their under-representation in clinical trials. 11,12 A recent retrospective cohort study concluded combining chemotherapy with local therapy offers diminishing benefits with advancing age, 13 a finding supported by Pignon et al in their 2009 meta-analysis of randomized control trials.…”

Section: Introductionmentioning

confidence: 99%

Age Alone Is Not a Barrier to Concurrent Chemoradiotherapy for Advanced Head and Neck Cancer

Sexton

Walsh

Moriarty

et al. 2022

Ann Otol Rhinol Laryngol

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Background: Head and Neck Cancer (HNC) is associated with significant morbidity and mortality, especially when high stage disease is present. There exists a range of options for the management of locoregionally advanced HNC, though doubt remains as to the optimal strategy in the elderly population. Aims: To evaluate the benefits imparted by concurrent chemoradiotherapy (CCRT) to the elderly population of HNC patients in Ireland. Methods: A retrospective cohort study was conducted using 20 years of cancer registry data provided by the National Cancer Registry of Ireland. Cox multivariate regression analysis was applied to test for the benefits of CCRT in HNC. Results: Survival analysis showed an overall benefit to the use of CCRT in patients with advanced disease over 70 years, particularly when used for hypopharyngeal, oropharyngeal, and laryngeal malignancy. There was a benefit to cancer-specific but not all-cause mortality in those over 75 years, and no benefit was observed to the addition of chemotherapy in those over 80 years; only 8 patients over 80 received CCRT. There was no statistically significant difference in the benefits derived by those over 70 years relative to those under 70 years. Conclusion: CCRT confers significant survival benefits to appropriately selected elderly HNC patients and should therefore not be withheld solely on the basis of age.

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“…We also collected potential confounders, including patient demographic factors (age, gender, and residency region), patient characteristics (social economic status and comorbidity), disease characteristics (clinical T-stage and N-stage), RT delivery using image-guided radiotherapy (IGRT) or other, and time period. All covariates were selected and modified by our experiences in clinical practice and other TCR/NHI related studies (17)(18)(19)(20)(21). The definitions of covariates were as follows: i) patient residency was classified as northern Taiwan or elsewhere, ii) socioeconomic status was classified as high (income greater than minimum wage) or not, iii) comorbidity was defined as with or without a modified Carlson comorbidity score ≥1, iv) clinical stage was classified as T1-T2 versus T3-T4 for T-stage and negative versus positive for N-stage, v) RT delivery was classified as IGRT or not, and vi) time period was classified as early (2007)(2008)(2009)(2010) or recent (2011)(2012)(2013)(2014)(2015).…”

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confidence: 99%

Effectiveness of Intensity-Modulated Radiotherapy for Rectal Cancer Patients Treated With Neoadjuvant Concurrent Chemoradiotherapy: A Population-based Propensity Score-matched Analysis

Liang

Chung

et al. 2019

Anticancer Res

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Background/Aim: Neoadjuvant concurrent chemoradiotherapy (nCCRT) is the standard of care for locally advanced rectal cancer (LARC) patients treated with neoadjuvant concurrent chemoradiotherapy (nCCRT). The aim of this study was to compare intensity-modulated radiotherapy (IMRT) to 3D conformal radiotherapy (3DCRT) in nCCRT patients. Patients and Methods: We identified LARC patients diagnosed from 2007 to 2015 through the Taiwan cancer registry (TCR) and we constructed a propensity score matched cohort to compare IMRT to 3DCRT after balancing observable potential confounders. We compared the hazard ratio (HR) of death as well as other endpoints between the IMRT and 3DCRT. We performed supplementary analysis (SA) when additional potential confounders were considered. Results: Our study population consisted of 696 patients. There was no statistical difference when IMRT was compared to 3DCRT (HR for death=1.01, 95%confidence interval(CI)=0. 76-1.35, p=0.93). There were also no statistical differences for the other endpoints or SA. Conclusion: For LARC patients treated with nCCRT, the treatment outcome has no statistically significant benefit between those treated with IMRT or 3DCRT.Rectal cancer is one of the leading cancers responsible for mortality worldwide (1). Radiotherapy is an important tool for locally advanced rectal cancer (LARC), while neoadjuvant concurrent chemoradiotherapy (nCCRT) has been the common standard of care for decades (2-4).Intensity-modulated radiotherapy (IMRT) is a 2nd generation advanced radiotherapy technology that allows highly conformal dose distribution (5). IMRT has been advocated for many cancer types, such as head-and-neck cancer, lung cancer, and prostate cancer (6-8), however, its role in rectal cancer was still debated in the current guidelines (9). A review paper published in 2016 stated: "There were no randomized control trials or prospective studies comparing IMRT with three-dimensional conformal radiotherapy (3DCRT) in rectal cancer", and none of the eight clinical studies mentioned in this review were population-based (10). Another systematic review published in 2018 also stated "Due to the sensitivity of IMRT to geometric errors, one might be concerned of the risk of missing the target volume, which can consequently affect oncologic outcomes" (11). This systematic review reported lower toxicity with IMRT (11). However, a landmark single arm phase II study (Radiation Therapy Oncology Group 0822) had reported that the use of IMRT in neoadjuvant chemoradiation for rectal cancer does not reduce the rate of GI toxicity (12). We have found only one relevant population-based study reporting the survival outcome of rectal cancer patients from North America (13). Due to the controversy of IMRT and the lack of population-based studies for rectal cancer, we aimed to compare the outcomes of locally advanced rectal cancer patients treated with neoadjuvant concurrent chemoradiotherapy (with IMRT versus 3DCRT) in this large population-based propensity score-matched analysis.

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Effectiveness of tomotherapy v s linear accelerator image-guided intensity-modulated radiotherapy for localized pharyngeal cancer treated with definitive concurrent chemoradiotherapy: a Taiwanese population-based propensity score-matched analysis

Cited by 6 publications

References 33 publications

Precision radiotherapy for nasopharyngeal carcinoma

Precision radiotherapy for nasopharyngeal carcinoma

Age Alone Is Not a Barrier to Concurrent Chemoradiotherapy for Advanced Head and Neck Cancer

Effectiveness of Intensity-Modulated Radiotherapy for Rectal Cancer Patients Treated With Neoadjuvant Concurrent Chemoradiotherapy: A Population-based Propensity Score-matched Analysis

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