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 2

Published studies with either IMRT or conventional techniques. Data included concomitant chemotherapy or not, follow-up, and radiation-induced toxicity.

Study Radiation treatment Concurrent
chemotherapy
No. of patients (%)
Median
followup (range)
Toxicity (≥GrII) Mean parotid- gland dose
MucositisXerostomia
AcuteLateAcuteLate

Studer et al. [24]IMRTYes (86%)16 mths (4–44 mths)65%
Lee et al. [8]IMRTYes31 mths (20–64 mths)66%66%12%
2DRTYes 46 mths (3–93 mths)72%65%67%
Garden et al. [25]IMRTYes (8%)45 mths (15–63 mths)23.9 Gy
Daly et al. [26]IMRTYes (87%)29 mths (4–105 mths)93%33.2 Gy
Chao et al. [27]IMRTYes (23%)33 mths (9–60 mths)86%12%18.6 Gy
Huang et al. [28]IMRTYes33 mths (3–72 mths)92%34%25.5 Gy
Setton et al. [29]IMRTYes (88%)36.8 mths (3–135 mths)68%28%29%25.8 Gy
Kwong et al. [34]IMRTNo24 mths (11–42 mths)82%40% (1yrs) 15% (2yrs) 38.8 Gy
Wolden et al. [35]IMRTYes (93%)35 mths (3–74 mths)32% (1yrs)35.2 Gy
Kam et al. [36]IMRTYes (30%)29 mths (8–45 mths)92%75%23% (2yrs) 39 Gy
16.7% (2yrs) 31 Gy
Lee et al. [38]IMRTYes (65%)31 mths (6–55 mths)22%33%
Lee et al. [40]IMRTYes (75%)31 mths (7–72 mths)94%58%
Liu et al. [41]IMRTYes (58%)13.0 mths (8–18 mths)79%53%37.8 Gy
Luo et al. [42] 3D-CRTNo58 mths (25–92 mths)74%12%12%52.8 Gy
Al-Mamgani
et al. [47]
IMRT + 3D-CRTYes(28.3%)32 mths (7–172 mths)14.1% 23.6 Gy
Lee et al. [50]IMRTYes (65%)26 mths (17–58 mths)48%3.2%26 Gy
Van Gestel et al. [51]IMRTYes
Def: 63%
Post: 23%
18.7 mths (0.13–51.7 mths)100%44%
Peponi et al. [52]IMRTYes (85%)55 mths Obj: 7.3 % Sub: 3.6%
Gupta et al. [23]3D-CRT Yes40 mths (26–50 mths)93%53 Gy
IMRT Yes (90%)40 mths (26–50 mths)77%34.3 Gy
Lambrecht et al. [18]3D-CRTYes (80%)68 mths (37.2–104 mths)44%68%53 Gy
IMRTYes (81%)35 mths (4.7–63.5 mths)32%23%34 Gy
Toledano et al. [53]IMRTYes (37.5%)25.3 mths (0.4–72 mths)~73%~58%
Clavel et al. [9]IMRTYes42 mths 75%8% (2yrs)
2-3DRTYes42 mths 77%74% (2yrs)
Vergeer et al. [20]IMRTYes (43%)32% (6 mths)27 Gy
3D-CRTYes (35%)56% (6 mths)43 Gy
Chen et al. [21]*IMRTYes (9%)44 mths87%36%
3D-CRTYes (2%)44 mths89%82%
Nutting et al. [12]IMRTYes (43%)44 mths93%71%69%36.5 Gy
3D-CRTYes (40%)44 mths94%91%76%61 Gy
Wong et al. [33]IMRTYes (70%)34 mths (9–50 mths)67.4%2.3%30 Gy
Sultanem et al. [44]IMRTYes (91%)21.8 mths (5–49 mths)97%28%
Su et al. [45]IMRTNo50.9 mths (12–104 mths)73%36%15.4% (1yrs) 9.0% (2yrs)31 Gy
Wang et al. [43]IMRTYes (83%)47.1 mths (11–68 mths)33.3%4.7%12.3% (2yrs)27.6 Gy
Rades et al. [22]*2DRT Yes (8%)~90%73%
3D-CRTYes (23%)~90%63%
IMRTYes (6%)~90%17%
Tham et al. [39]IMRTYes36.5 mths29% (Gr3)3% (Gr3)
IMRTNo36.5 mths20% (Gr3)
Kim et al. [46] 3D-CRTNo48 mths57%19%
De Arruda et al. [32]IMRTYes (86%)18 mths (8.4–76 mths)92%60%33%26.5 Gy

Postoperative RT; definitive and postoperative RT; all the rest: definitive RT.