Systematic reviewIntensity-modulated radiation therapy for head and neck cancer: Systematic review and meta-analysis
Section snippets
Study design
This was a systematic review carried out in accordance with The Cochrane Collaboration Handbook of Interventions Systematic Reviews [7]. The manuscript was prepared using the PRISMA Statement as a reporting guide [8].
Criteria for considering studies for this review
Only prospective phase III randomized trials were considered. Eligible trials had to compare IMRT with 2D-RT or 3D-CRT in previously untreated patients, with non-metastatic head and neck cancers.
Patients were treated with radiotherapy either primarily or combined with surgery or
Study selection and characteristics of the included studies
Six papers corresponding to five studies fulfilled the eligibility criteria [16], [17], [18], [19], [20], [21]. The flowchart of the retrieved studies and the main characteristics of the included studies are presented in Fig. 1 and Table 1, respectively.
In these five studies, 871 patients were randomly assigned for 2D-RT or 3D-CRT (437), versus IMRT (434). Except for Gupta et al. [19], [20], all studies compared 2D-RT with IMRT. Three studies included only patients with nasopharynx cancers [16]
Discussion
Head and neck tumors are curable even for locally advanced presentations, either with surgery or RT alone or with combined treatments (surgery, RT and chemotherapy). Usually, loco-regional control is directly related to survival since these tumors tend to grow locally rather than metastasize. The head and neck anatomy favors RT in the sense that high doses can be safely delivered to this site. However, more sensitive structures like the parotid glands may suffer the effect of high radiation
Financial disclosure/acknowledgements
None to declare.
Conflict of interest statement
None to declare.
References (37)
- et al.
Dose, volume, and function relationships in parotid salivary glands following conformal and intensity-modulated irradiation of head and neck cancer
Int J Radiat Oncol Biol Phys
(1999) - et al.
Intensity-modulated radiotherapy in the treatment of nasopharyngeal carcinoma: an update of the UCSF experience
Int J Radiat Oncol Biol Phys
(2002) - et al.
Intensity-modulated radiation therapy for oropharyngeal carcinoma: impact of tumor volume
Int J Radiat Oncol Biol Phys
(2004) - et al.
Toxicity criteria of the Radiation Therapy Oncology Group (RTOG) and the European Organization for Research and Treatment of Cancer (EORTC)
Int J Radiat Oncol Biol Phys
(1995) - et al.
Xerostomia and quality of life after intensity-modulated radiotherapy vs. conventional radiotherapy for early-stage nasopharyngeal carcinoma: initial report on a randomized controlled clinical trial
Int J Radiat Oncol Biol Phys
(2006) - et al.
Parotid-sparing intensity modulated versus conventional radiotherapy in head and neck cancer (PARSPORT): a phase 3 multicentre randomised controlled trial
Lancet Oncol
(2011) - et al.
Prospective assessment of patterns of failure after high-precision definitive (chemo) radiation in head-and-neck squamous cell carcinoma
Int J Radiat Oncol Biol Phys
(2011) - et al.
Three-dimensional conformal radiotherapy (3D-CRT) versus intensity modulated radiation therapy (IMRT) in squamous cell carcinoma of the head and neck: a randomized controlled trial
Radiother Oncol
(2012) - et al.
A prospective, randomized study comparing outcomes and toxicities of intensity-modulated radiotherapy vs. conventional two-dimensional radiotherapy for the treatment of nasopharyngeal carcinoma
Radiother Oncol
(2012) - et al.
Intensity-modulated radiotherapy versus conventional and 3D conformal radiotherapy in patients with head and neck cancer: is there a worthwhile quality of life gain?
Cancer Treat Rev
(2011)
Comparison of treatment plans involving intensity-modulated radiotherapy for nasopharyngeal carcinoma
Int J Radiat Oncol Biol Phys
The potential for sparing of parotids and escalation of biologically effective dose with intensity-modulated radiation treatments of head and neck cancers: a treatment design study
Int J Radiat Oncol Biol Phys
The impact of introducing intensity modulated radiotherapy into routine clinical practice
Radiother Oncol
Time and motion study of radiotherapy delivery: economic burden of increased quality assurance and IMRT
Radiother Oncol
Intensity-modulated radiotherapy reduces radiation-induced morbidity and improves health-related quality of life: results of a nonrandomized prospective study using a standardized follow-up program
Int J Radiat Oncol Biol Phys
Impact of intensity modulated radiotherapy on health-related quality of life for head and neck cancer patients: matched-pair comparison with conventional radiotherapy
Int J Radiat Oncol Biol Phys
Xerostomia and its predictors following parotid sparing irradiation of head-and-neck cancer
Int J Radiat Oncol Biol Phys
A prospective study of salivary function sparing in patients with head-and-neck cancers receiving intensity-modulated or three-dimensional radiation therapy: initial results
Int J Radiat Oncol Biol Phys
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