Intensity-modulated radiation treatment for head-and-neck squamous cell carcinoma—the University of Iowa experience

Yao, Min; Dornfeld, Kenneth J.; Buatti, John M.; Skwarchuk, Mark W.; Tan, Huaming; Nguyen, Thanh V.; Wacha, Judith; Bayouth, John E.; Funk, Gerry F.; Smith, Russell B.; Graham, Scott M.; Chang, Kristi; Hoffman, Henry T.

doi:10.1016/j.ijrobp.2005.02.025

Cited by 178 publications

(129 citation statements)

References 32 publications

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“…They are either very heterogeneous regarding tumor sites and stages [9,11,12,41,43] or have relatively small patient numbers [8,41], and all series suffer from a relatively short follow-up. Potential patient selection factors are probably the most important issues that should be considered in assessing outcome in retrospective series of IMRT.…”

Section: Imrt For Oropharyngeal Carcinomamentioning

confidence: 99%

“…These factors make any attempt to compare the results of different IMRT series, or even series of IMRT with series of conventional RT, futile. Notwithstanding these limitations, all series of IMRT outcome have reported outstanding locoregional control rates for oropharyngeal cancer [11,12,[43][44][45]. These series reported 2-year locoregional tumor control rates of 90%-98% for patient populations consisting mainly of stage III-IV tumors.…”

Section: Imrt For Oropharyngeal Carcinomamentioning

confidence: 99%

“…Following these observations, we currently define the retropharyngeal nodes through the base of the skull. Interesting observations about marginal or out-of-field recurrences were reported in the series from the University of Iowa [43]. They found several cases of recurrence in the contralateral level I in patients with lateral oral cavity and oropharyngeal cancer, underscoring the need to include these nodes in locoregionally advanced oral cancer.…”

Section: Imrt For Oropharyngeal Carcinomamentioning

confidence: 99%

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Intensity-Modulated Radiation Therapy for Head and Neck Carcinoma

et al. 2007

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After completing this course, the reader will be able to:1. Outline innovations related to targeted radiation therapy.2. Describe trials proving an advantage using IMRT.3. Assess treatment planning modalities and how IMRT fields are designed.4. Evaluate when there is a toxicity advantage for IMRT.5. Discern when conventional radiotherapy should be used instead of IMRT.Access and take the CME test online and receive 1 AMA PRA Category 1 Credit ™ at CME.TheOncologist.com CME CME ABSTRACT Intensity-modulated radiation therapy (IMRT) for head and neck tumors refers to a new approach that aims at increasing the radiation dose gradient between the target tissues and the surrounding normal tissues at risk, thus offering the prospect of increasing the locoregional control probability while decreasing the complication rate. As a prerequisite, IMRT requires a proper selection and delineation of target volumes. For the latter, recent data indicate the potential of functional imaging to complement anatomic imaging modalities. Nonrandomized clinical series in paranasal sinuses and pharyngolaryngeal carcinoma have shown that IMRT was able to achieve a very high rate of locoregional control with less morbidity, such as dry-eye syndrome, xerostomia, and swallowing dysfunction. The promising results of IMRT are likely to be achieved when many treatment conditions are met, for example, optimal selection and delineation of the target volumes and organs at risk, appropriate physical quality control of the irradiation, and accurate patient setup with the use of onboard imaging. Because of the complexity of the various tasks, it is thus likely that these conditions will only be

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Section: Imrt For Oropharyngeal Carcinomamentioning

confidence: 99%

Section: Imrt For Oropharyngeal Carcinomamentioning

confidence: 99%

Section: Imrt For Oropharyngeal Carcinomamentioning

confidence: 99%

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Intensity-Modulated Radiation Therapy for Head and Neck Carcinoma

et al. 2007

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“…These patients had a minimum of one year follow-up without recurrence and had also completed a validated health related quality of life questionnaire, the HNCI. All were treated with IMRT and details of the radiotherapy have been described (24). The patients studied for the current report are a subset of 18 from a larger group of 27 patients also treated with chemoradiotherapy and followed using the HNCI.…”

Section: Resultsmentioning

confidence: 99%

“…These patients received cisplatin-based chemotherapy concurrently with radiotherapy delivered via intensity modulated radiation therapy (IMRT) (1,24). The details of the IMRT have been reported previously (24). Briefly, areas of gross disease were treated using 2 Gy daily fractions to 66-74 Gy.…”

Section: Patientsmentioning

confidence: 99%

Posttreatment FDG-PET Uptake in the Supraglottic and Glottic Larynx Correlates With Decreased Quality of Life After Chemoradiotherapy

Dornfeld

Hopkins

Simmons

et al. 2008

International Journal of Radiation Oncology*Biology*Physics

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Purpose-Inflammation and increased metabolic activity associated with oxidative stress in irradiated normal tissues may contribute to both complications following radiotherapy and increased glucose uptake as detected by post-therapy FDG PET imaging. We sought to determine if increased glucose uptake in normal tissues after chemoradiotherapy is associated with increased toxicity.Methods-Consecutive patients with locoregionally advanced head and neck cancers treated with IMRT and free of recurrence at one year were studied. FDG-PET imaging was obtained at 3 and 12 months post-treatment. SUV levels were determined at various head and neck regions. Functional outcome was measured using a quality of life questionnaire and weight loss and type of diet tolerated one year after therapy. A one-tailed Pearson correlation test was used to examine associations between SUV levels and functional outcome measures.Results-SUV levels in the supraglottic and glottic larynx from FDG PET imaging obtained 12 months post-treatment were inversely associated with quality of life measures and were correlated with a more restricted diet one year after therapy. SUV levels at 3 months after therapy did not correlate with functional outcome. Increases in SUV levels in normal tissues between 3 and 12 months were commonly found in the absence of recurrence.Conclusion-Altered metabolism in irradiated tissues persists one year after therapy. FDG PET scans may be used to assess normal tissue damage following chemoradiotherapy. These data support investigating hypermetabolic conditions associated with inflammation and\or oxidative stress as causal agents for radiation induced normal tissue damage.

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