Intensity-modulated radiation therapy for head and neck cancer: Systematic review and meta-analysis

Intensity-modulated radiation therapy for head and neck cancer: Systematic review and meta-analysis

Author Marta, Gustavo Nader Google Scholar
Silva, Valter Autor UNIFESP Google Scholar
Carvalho, Heloisa de Andrade Google Scholar
Arruda, Fernando Freire de Google Scholar
Hanna, Samir Abdallah Google Scholar
Gadia, Rafael Google Scholar
Fernandes da Silva, Joao Luis Google Scholar
Miranda Correa, Sebastiao Francisco Google Scholar
Cintra Vita Abreu, Carlos Eduardo Google Scholar
Riera, Rachel Autor UNIFESP Google Scholar
Institution Hosp Sirio Libanes
Inst Canc São Paulo ICESP
Universidade Federal de São Paulo (UNIFESP)
Universidade de São Paulo (USP)
Abstract Background and purpose: Intensity-modulated radiation therapy (IMRT) provides the possibility of dose-escalation with better normal tissue sparing. This study was performed to assess whether IMRT can improve clinical outcomes when compared with two-dimensional (2D-RT) or three-dimensional conformal radiation therapy (3D-CRT) in patients with head and neck cancer.Methods and materials: Only prospective phase III randomized trials comparing IMRT with 2D-RT or 3D-CRT were eligible. Combined surgery and/or chemotherapy were allowed. Two authors independently selected and assessed the studies regarding eligibility criteria and risk of bias.Results: Five studies were selected. A total of 871 patients were randomly assigned for 2D-RT or 3D-CRT.(437), versus IMRT (434). Most patients presented with nasopharyngeal cancers (82%), and stages III/IV (62.1%). Three studies were classified as having unclear risk and two as high risk of bias. A significant overall benefit in favor of IMRT was found (hazard ratio - HR = 0.76; 95% CI: 0.66, 0.87; p < 0.0001) regarding xerostomia scores grade 2-4, with similar loco-regional control and overall survival.Conclusions: IMRT reduces the incidence of grade 2-4 xerostomia in patients with head and neck cancers without compromising loco-regional control and overall survival. (C) 2013 Elsevier Ireland Ltd. All rights reserved. Radiotherapy and Oncology 110 (2014) 9-15
Keywords Head and neck cancer
Intensity-modulated radiation therapy
Three-dimensional conformal radiation therapy
Language English
Date 2014-01-01
Published in Radiotherapy and Oncology. Clare: Elsevier B.V., v. 110, n. 1, p. 9-15, 2014.
ISSN 0167-8140 (Sherpa/Romeo, impact factor)
Publisher Elsevier B.V.
Extent 9-15
Access rights Closed access
Type Review
Web of Science ID WOS:000333792100003

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