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Title: Intensity-modulated radiation therapy for head and neck cancer: Systematic review and meta-analysis
Authors: Marta, Gustavo Nader
Silva, Valter [UNIFESP]
Carvalho, Heloisa de Andrade
Arruda, Fernando Freire de
Hanna, Samir Abdallah
Gadia, Rafael
Fernandes da Silva, Joao Luis
Miranda Correa, Sebastiao Francisco
Cintra Vita Abreu, Carlos Eduardo
Riera, Rachel [UNIFESP]
Hosp Sirio Libanes
Inst Canc São Paulo ICESP
Universidade Federal de São Paulo (UNIFESP)
Universidade de São Paulo (USP)
Keywords: Head and neck cancer
Intensity-modulated radiation therapy
Three-dimensional conformal radiation therapy
Issue Date: 1-Jan-2014
Publisher: Elsevier B.V.
Citation: Radiotherapy and Oncology. Clare: Elsevier B.V., v. 110, n. 1, p. 9-15, 2014.
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
ISSN: 0167-8140
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