+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Preliminary results of concurrent chemotherapy with intensity-modulated radiation therapy (IMRT) for advanced cancer of the larynx/hypopharynx



Preliminary results of concurrent chemotherapy with intensity-modulated radiation therapy (IMRT) for advanced cancer of the larynx/hypopharynx



Journal of Clinical Oncology 24(18_Suppl): 5544-5544



NlmCategory="UNASSIGNED">5544 Purpose: Retrospective review of an institution's IMRT experience in treating advanced laryngeal/hypopharyngeal carcinoma with concurrent chemotherapy. Between 1/02-6/05, 31 patients with advanced laryngeal/hypopharyngeal carcinoma (74% T3/T4 disease;71% stage IV) underwent combined modality treatment. There were 20 laryngeal and 11 hypopharyngeal carcinomas. All patients received definitive IMRT with a median RT dose of 70 Gy. Concurrent chemotherapy was also given to all patients [cis-platinum (100mg/m2/cycle) or carboplatin/5-fluorouracil (J Clin Oncol 2004;22:69) every 3 weeks for 2-3 planned cycles; 3 patients received a weekly paclitaxel/carboplatin program]. Prophylactic feeding tubes (PEG) were placed in all patients. Acute toxicity and late xerostomia were scored using the RTOG radiation morbidity scale. The 2-year estimates for local progression-free rate (LPF), regional progression-free rate (RPF), distant metastases-free rate (DMF), and overall survival (OS) were calculated using the Kaplan-Meier method. With a median follow-up of 17 months (range: 7-48), 2-year estimates of LPF, RPF, DMF, and OS rates were 76%, 94%, 96%, 87%, respectively. All patients with local failure of laryngeal carcinoma had persistent disease at the end of treatment. Grade ≥2 mucositis was experienced by 68% of the patients during treatment. Xerostomia continued to decrease over time from the end of RT and only 4 still complained of Grade 2 xerostomia. A greater proportion of patients with hypopharynx than larynx cancer were still PEG-dependent (55% versus 25%) after combined modality treatment at the time of this analysis. One patient developed laryngeal necrosis. These preliminary results show that IMRT, in combination with chemotherapy, achieved encouraging local control rates in patients with advanced laryngeal/hypopharyngeal carcinoma. Xerostomia improved over time. Pharyngoesophageal stricture with PEG dependency remains a problem especially in patients with hypopharyngeal carcinoma. Strategies using the ability of IMRT to limit the dose delivered to the esophagus and inferior constrictor musculature may be useful to further minimize this late complication. No significant financial relationships to disclose.

Please choose payment method:






(PDF emailed within 1 workday: $29.90)

Accession: 058604073

Download citation: RISBibTeXText

PMID: 27954507


Related references

Intensity Modulated Radiation Therapy With Concurrent Chemotherapy for Larynx Preservation in Locally Advanced Larynx Cancer: A National Cancer Database Study. International Journal of Radiation Oncology*biology*physics 99(2): E382-E383, 2017

Hypothyroidism as a consequence of intensity-modulated radiation therapy (IMRT) with concurrent taxane-based chemotherapy for locally-advanced head and neck cancer (LAHNC). Journal of Clinical Oncology 26(15_Suppl): 6048-6048, 2016

Clinical study on concurrent and sequential therapy of intensity modulated radiation therapy (IMRT) combined with NP regimen chemotherapy in the treatment of middle and advanced non-small cell lung cancer. Chinese-German Journal of Clinical Oncology 6(1): 2-4, 2007

Intensity-modulated radiation therapy (IMRT) with concurrent taxane-based chemotherapy for locally-advanced head and neck cancer(LAHNC): Feasibility, technique, and toxicities. Journal of Clinical Oncology 23(16_Suppl): 5536-5536, 2016

Concurrent Chemotherapy (Cht) And Intensity Modulated Radiation Therapy (Imrt) Versus Imrt Alone For The Treatment (Tt) Of Stage (Stg) IiiIv Oropharyngeal Carcinoma (Opc): A Retrospective Study At The Nova Scotia Cancer Centre (Nscc). Radiotherapy and Oncology 92: S44-S45, 2009

Phase II study of induction chemotherapy with TPF followed by radioimmunotherapy with Cetuximab and intensity-modulated radiotherapy (IMRT) in combination with a carbon ion boost for locally advanced tumours of the oro-, hypopharynx and larynx--TPF-C-HIT. Bmc Cancer 11(): 182-182, 2011

Sequential four-drug chemotherapy and intensity-modulated radiotherapy for larynx preservation in resectable advanced larynx and hypopharynx cancer: A pilot study. American Journal of Otolaryngology 38(1): 52-56, 2016

Preliminary results in prostate cancer patients treated with high-dose-rate brachytherapy and intensity modulated radiation therapy (IMRT) vs. IMRT alone. BrachyTherapy 9(4): 341-348, 2011

Preliminary results of a phase II neoadjuvant trial with gemcitabine/oxaliplatin and cetuximab followed by surgery or concurrent intensity modulated radiation therapy (IMRT) with capecitabine for patients with borderline resectable and unresectable nonmetastatic pancreatic cancer. Journal of Clinical Oncology 26(15_Suppl): 15506-15506, 2016

A Phase I Study of Concurrent Capecitabine and Intensity Modulated Radiation Therapy(IMRT) as Adjuvant Treatment for Locally Advanced Gastric Cancer. International Journal of Radiation Oncology*biology*physics 84(3): S315-S316, 2012

Concurrent chemotherapy with intensity-modulated radiation therapy for locally advanced squamous cell carcinoma of the larynx and oropharynx: a retrospective single-institution analysis. Head and Neck 31(11): 1447-1455, 2010

A multi-institutional acute gastrointestinal toxicity analysis of anal cancer patients treated with concurrent intensity-modulated radiation therapy (IMRT) and chemotherapy. RadioTherapy and Oncology 93(2): 298-301, 2010

Outcomes of Induction Chemotherapy Plus Intensity-Modulated Radiotherapy (IMRT) Versus IMRT Plus Concurrent Chemotherapy for Locoregionally Advanced Nasopharyngeal Carcinoma: A Propensity Matched Study. Translational Oncology 9(4): 329-335, 2016

Efficacy of concurrent cetuximab vs. 5-fluorouracil/carboplatin or high-dose cisplatin with intensity-modulated radiation therapy (IMRT) for locally-advanced head and neck cancer (LAHNSCC). Oral Oncology 50(10): 947-955, 2015

Definitive intensity-modulated radiation therapy with concurrent chemotherapy for patients with locally advanced cervical cancer. Gynecologic Oncology 122(1): 9-13, 2011