BioMed Research International / 2013 / Article / Tab 1 / Review Article
The Treatment Outcome and Radiation-Induced Toxicity for Patients with Head and Neck Carcinoma in the IMRT Era: A Systematic Review with Dosimetric and Clinical Parameters Table 1 Published studies with either IMRT or conventional techniques. Data included primary site, stage, intention of RT, concomitant chemotherapy or not, followup, and treatment outcome.
Study
No. of patients
Primary tumor site
TN stage RT
Intention for RT
Concurrent chemotherapy Median followup (Range) Treatment outcome % Regional control (RC)
Local control (LC) Locoregional control (LRC)
Distant metastases-free survival (DMFS) Disease-free survival (DFS)
Overall survival (OS) no. of pts (%) no. of pts (%) Studer et al. [24 ] 29 Hypopharynx
T1–T4 N0–N3 IMRT
Def: 90% Post: 10% YES (86%)
16 mths (4–44 mths)
93% (2yrs)
90% (2yrs) — 93% (2yrs) 90% (2yrs) —
Lee et al. [8 ] 41 Oropharynx T1–T4 N0–N3 St: III–IVB IMRT Def Yes 31 mths (20–64 mths) 94% (3yrs) 95% (3yrs) 92% (3yrs) 86% (3yrs) 82% (3yrs) 91% (3yrs) 71 Oropharynx T1–T4 N0–N3 St: III–IVB 2DRT Def Yes 46 mths (3–93 mths) 95% (3yrs) 85% (3yrs) 82% (3yrs) 85% (3yrs) 76% (3yrs) 81% (3yrs) Garden et al. [25 ] 51 Oropharynx Tx, T1-T2 Nx, N0–N3 IMRT Def Yes (8%) 45 mths (15–63 mths) — 96% (2yrs) 93% (2yrs) — 87% (2yrs) 93% (2yrs) Daly et al. [26 ] 107 Oropharynx T1–T4 N0–N3 St: II–IV IMRT Def: 80% Post: 20% Yes (87%) 29 mths (4–105 mths) — — 92% (3yrs) 92% (3yrs) 81% (3yrs) 83% (3yrs) Chao et al. [27 ] 74 Oropharynx T1–T4 N0–N3 St: I–IV IMRT Def: 42% Post: 58% Yes (23%) 33 mths (9–60 mths) — — 87% (3yrs) 90% (4yrs) 81% (4yrs) 87% (4yrs) Huang et al. [28 ] 71 Oropharynx T1–T4 N0–N3 St: III-IV IMRT Def Yes 33 mths (3–72 mths) 94% (3yrs) 94% (3yrs) 90% (3yrs) — — 83% (3yrs) Setton et al. [29 ] 442 Oropharynx T1–T4 N0–N3 St: I–IV IMRT Def: 93% Post: 7% Yes (88%) 36.8 mths (3–135 mths) 94.4% (3yrs) 94.6% (3yrs) — 87.5% (3yrs) — 84.9% (3yrs) Schoenfeld et al. [30 ] 64 Oropharynx T1–T4 N0–N3 St: I–IVB IMRT Def Yes (54%) 36 mths (12–62 mths) 94% (3yrs) 90% (3yrs) — RFS: 86% (3yrs) 84% (3yrs)
Clavel et al. [9 ] 100 Oropharynx T1–T4 N0–N3 St: III–IVB IMRT Def Yes 42 mths 95.1% (3yrs) 85.3% (3yrs) 92.1% (3yrs) 149 Oropharynx T1–T4 N0–N3 St: III–IVB 2-3DRT Def YES 42 mths 84.4% (3yrs) 69.3% (3yrs) 75.2% (3yrs) Sanguineti et al. [31 ] 50 Oropharynx Tx, T1–T4 N0–N3 IMRT Def No 32.6 mths (12.1–58.6 mths) 85% (3yrs) 94% (3yrs)
De Arruda et al. [32 ] 50 Oropharynx T1–T4 N0–N3 St: I–IV IMRT Def: 96% Post: 4% Yes (86%) 18 mths (8.4–76 mths) 88% (2yrs) 98% (2yrs) 84% (2yrs) 98% (2yrs)
Fang et al. [10 ] 113 Nasopharynx T1–T4 N0–N3 St: I–IV IMRT Def Yes (57.3%) 40 mths (5–57 mths) — — 84% (3yrs) 83% (3yrs) — 85% (3yrs) 93 Nasopharynx T1–T4 N0–N3 St: I–IV 3D-CRT Def Yes (54.8%) 46 mths (10–59 mths) — — 84.8% (3yrs) 76.7% (3yrs) — 81.7% (3yrs) Wong et al. [33 ] 175 Nasopharynx T1–T4 N0–N3 St: I–IVB IMRT Def Yes (70%) 34 mths (9–50 mths) 93.3% (3yrs) 93.6% (3yrs) 86.6% (3yrs) 87.2% (3yrs) Kwong et al. [34 ] 33 Nasopharynx
T1–T3 N0-N1 IMRT Def No
24 mths (11–42 mths)
93% (3yrs)
100% (3yrs) — 100% (3yrs) — 100% (3yrs) Wolden et al. [35 ] 74 Nasopharynx T1–T4 N0–N3 St: I–IVB IMRT Def Yes (93%) 35 mths (3–74 mths) 93% (3yrs) 91% (3yrs) — 78% (3yrs) 67% (3yrs) 83% (3yrs) Kam et al. [36 ] 63 Nasopharynx T1–T4 N0–N3 St: I–IV IMRT Def Yes (30%) 29 mths (8–45 mths) 98% (3yrs) 92% (3yrs) — 79% (3yrs) — 90% (3yrs) Tham et al. [37 ] 107 Nasopharynx T1–T2 N0–N1 St: IIB IMRT Def Yes (7%) 39 mths (7–77 mths) 98% (3yrs) 96.5% (3yrs) 94.8% (3yrs) 90.7% (3yrs) 95.8% (3yrs) Lee et al. [38 ] 68 Nasopharynx T1–T4 N0–N3 St: I–IVB IMRT Def Yes (65%) 31 mths (6–55 mths) 90.8% (2yrs) 92.6% (2yrs) 89.3% (2yrs) 84.7% (2yrs) 72.7% (2yrs) 80.2% (2yrs) Tham et al. [39 ] 195 Nasopharynx T1–T4 N0–N3 St: I–IVB IMRT Def Yes (57%) 36.5 mths 89.6% (3yrs) 89.2% (3yrs) 79% (3yrs) 94.3% (3yrs) Lee et al. [40 ] 67 Nasopharynx T1–T4 N0–N3 St: I–IV IMRT Def Yes (75%) 31 mths (7–72 mths) 98% (4yrs) 97% (4yrs) — 66% (4yrs) — 88% (4yrs) Liu et al. [41 ] 19 Nasopharynx T1–T4 N0–N3 St: I–IV IMRT Def Yes (58%) 13.0 mths (8–18 mths) — — 100% (13 mths) Luo et al. [42 ] 58 Nasopharynx T1–T4 N0–N3 St: I-II 3D-CRT Def No 58 mths (25–92 mths) — — 93% (5yrs) 98% (5yrs) 91% (5yrs) 95% (5yrs) Wang et al. [43 ] 300 Nasopharynx T1–T4 N0–N3 St: IIB IMRT Def Yes (83%) 47.1 mths (11–68 mths) 95.1% (4yrs) 94% (4yrs) — 85% (4yrs) — 86.1% (4yrs) Sultanem et al. [44 ] 35 Nasopharynx T1–T4 N0–N3 St: I–IVB IMRT Def Yes (91%) 21.8 mths (5–49 mths) 100% (4yrs) 57% (4yrs) 57% (4yrs) 94% (4yrs) Su et al. [45 ] 198 Nasopharynx T1-T2 N0-N1 St: I–IIB IMRT Def No 50.9 mths (12–104 mths) 97.7% (5yrs) 97.8% (5yrs) 97.3% (5yrs)
Kim et al. [46 ] 21 Nasopharynx T2–T4 N0–N2 St: III-IV 3D-CRT Def No 48 mths 85% (5yrs) 61% (5yrs)
Al-Mamgani et al. [47 ] 170 Larynx T3 N0–N3 IMRT + 3D-CRT Def Yes (28.3%) 32 mths (7–172 mths) — 73% (3yrs) 70% (3yrs) 64% (3yrs) 61% (3yrs) Studer et al. [48 ] 58 Oral cavity Def T2–T4 N0–N3 St: IVA-BPost T1–T4 N0–N2c St: II–IVAIMRT Def: 52% Post: 48% Yes (78%) Def: 19 mths Post: 12 mths Def: 43% (2yrs) Post: 92% (2yrs) — — Def: 40% (2yrs) Post: 87% (2yrs) Def: 30% (2yrs) Post: 83% (2yrs)
Chen et al. [21 ] 22 Oral cavity
T1–T4 N0–N2c St: III-IV IMRT Post Yes (9%) 44 mths 64% (3yrs) 67% (3yrs) 27 Oral cavity T1–T4 N0–N2c St: III-IV 3D-CRT Post Yes (2%) 44 mths 66% (3yrs) 77% (3yrs) Yao et al. [49 ] 55 Oral cavity Tx–T4 N0–N2c St: I–IV IMRT Def: 9% Post: 91% Yes Def: 6% Post: 4% 23.9 mths (9.3–59.3 mths) 85% (3yrs) 82% (3yrs) 89% (3yrs) 74% (3yrs)* 68% (3yrs) Lee et al. [50 ] 31 Various T1–T4 N0–N2 St: I–IVB IMRT Def Yes (65%) 26 mths (17–58 mths) 86% (2yrs) 94% (2yrs) 92% (2yrs) 63% (2yrs)
Van Gestel et al. [51 ] 78 Various Tx, T1–T4 Nx, N0–N3 St: I–IVB IMRT Def: 62% Post: 38% Yes Def: 63% Post: 23% 18.7 mths (0.13–51.7 mths) Def: 66.8% (3yrs) Post: 82.2% (3yrs) Def: 42.6% (3yrs) Post: 82.2% (3yrs) Def: 60.3% (3yrs) Post: 85.9% (3yrs) Peponi et al. [52 ] 82 Various St: I–IV IMRT Def: 77% Post: 23% Yes (85%) 55 mths 78% (3yrs) 80% (3yrs)
Gupta et al. [23 ] 28 Various T1–T3 N0–N2b St: I–IV 3D-CRT Def Yes 40 mths (26–50 mths) 88.2% (3yrs) 70.6% (3yrs) 32 Various T1–T3 N0–N2b St: I–IV IMRT Def Yes (90%) 40 mths (26–50 mths) 88.2% (3yrs) 68% (3yrs)
Lambrecht et al. [18 ] 135 Various T1–T4 N0–N3 St: III-IV 3D-CRT Def Yes (80%) 68 mths (37.2–104 mths) 71% (3yrs) 61% (3yrs) 110 Various T1–T4 N0–N3 St: III-IV IMRT Def Yes (81%) 35 mths (4.7–63.5 mths) 70% (3yrs) 64% (3yrs) Toledano et al. [53 ] 208 Various St: I–IV IMRT Def: 55% Post: 45% Yes (37.5%) 25.3 mths (0.4–72 mths) — — 86% (2yrs)
92.7% (2yrs) 80% (2yrs) 86.7% (2yrs)
Rades et al. [22 ] 104 Various T0–T4 N0–N3 St: I–IV 2DRT Post Yes (8%) 78% (2yrs) 79% (2yrs) 74% (2yrs) 26 Various T0–T4 N0–N3 St: I–IV 3D-CRT Post Yes (23%) 79% (2yrs) 83% (2yrs) 80% (2yrs) 18 Various T0–T4 N0–N3 St: I–IV IMRT Post Yes (6%) 89% (2yrs) 80% (2yrs) 86% (2yrs) Yao et al. [54 ] 150 Various T0–T4 N0–N3 St: I–IV IMRT Def: 66% Post: 34% Yes (45%) 18 mths (2–60 mths) 94% (2yrs) 92% (2yrs) 87% (2yrs) 85% (2yrs)