IMRT controls head and neck cancer reducing radiation side effects

Intensity modulated radiation therapy, also known as IMRT, when used alone or combined with surgery, has been shown to greatly increase the chance for survival for patients with head and neck cancer while greatly reducing painful side effects, according to a new study in the May 2004 issue of the International Journal of Radiation Oncology-Biology-Physics, the official journal of ASTRO, the American Society for Therapeutic Radiology and Oncology.

Beginning in 1997, 74 patients with squamous cell carcinoma of the oropharynx were treated with IMRT. Seventy percent of the patients were at Stage IV, or a very advanced stage of cancer, with the remainder being at an earlier stage. After being treated with IMRT, the estimated four-year survival of all patients was 87 percent. Eighty-one percent of those patients were estimated to be completely disease free after completing treatment. If patients had surgery to remove the tumor in addition to being treated with IMRT, the chances of survival rose dramatically to 92 percent. Without surgery, 66 percent of the patients survived.

“This is the largest IMRT study in patients with oropharyngeal cancer and the results are very promising,” said K.S. Clifford Chao, M.D., the lead author of the study and a member of the department of radiation oncology at the University of Texas M.D. Anderson Cancer Center in Houston.

Another important finding of this report is that the use of IMRT also reduced painful side effects of the treatment and allowed for more normal post-treatment salivary function. Of the 74 patients in the study, 32 reported Grade I or mild dry mouth, 9 reported moderate dry mouth and 33 had no complaints at all.

“When administered correctly, IMRT alone or combined with surgery helps to cure patients of their disease while improving their quality of life by reducing painful side effects, such as dry mouth,” said Dr. Chao. He added that gross tumor size is one of the most important predictors of treatment success. In patients with a more advanced tumor, tumor control rate is lower and surgery is less likely an option.

ASTRO is the largest radiation oncology society in the world, with more than 7,500 members who specialize in treating patients with radiation therapies. As a leading organization in radiation oncology, biology and physics, the Society is dedicated to the advancement of the practice of radiation oncology by promoting excellence in patient care, providing opportunities for educational and professional development, promoting research and disseminating research results and representing radiation oncology in a rapidly evolving socioeconomic healthcare environment.