%0 Journal Article
%T Postoperative IMRT in head and neck cancer
%A Gabriela Studer
%A Katrin Furrer
%A Bernard J Davis
%A Sandro S Stoeckli
%A Roger A Zwahlen
%A Urs M Luetolf
%A Christoph Glanzmann
%J Radiation Oncology
%D 2006
%I BioMed Central
%R 10.1186/1748-717x-1-40
%X Between January 2002 and August 2006, 71 patients were consecutively treated with pIMRT for a squamous cell carcinoma (SCC) of the oropharynx (32), oral cavity (22), hypopharynx (7), larynx (6), paranasal sinus (3), and an unknown primary, respectively. Mean and median follow up was 19 months (2¨C48), and 17.6 months. 83% were treated with IMRT-chemotherapy. Mean prescribed dose was 66.3 Gy (60¨C70), delivered with doses per fraction of 2¨C2.3 Gy, respectively.2-year local, nodal, and distant control rates were 95%, 91%, and 96%, disease free and overall survival 90% and 83%, respectively. The corresponding survival rates for the subgroup of patients with a follow up time >12 months (n = 43) were 98%, 95%, 98%, 93%, and 88%, respectively. Distribution according to histopathologic risk features revealed 15% and 85% patients with intermediate and high risk, respectively. All loco-regional events occurred in the high risk subgroup.Surgery followed by postoperative IMRT in patients with substantial risk for recurrence resulted in high loco-regional tumor control rates compared with large prospective 3DCRT trials.Despite high dose postoperative irradiation in patients with locally advanced head and neck cancer (HNC) with certain high risk factors, loco-regional recurrences occur in approximately 30% of the cases [1,2]. Three randomized studies showed an increase of loco-regional control and overall survival when postoperative radiation and concomitant chemotherapy are combined [2-4] (Table 1). Accelerating treatment by using concomitant boost did not result in a clear improvement of loco-regional control [5] except perhaps in patients with a longer interval between surgery and radiation. In our own experience in postoperative radiation using concomitant boost, local control was 83% in accelerated vs 68% with conventional fractionation (S Maurer, dissertation, Radiation Oncology, University Hospital of Zurich, 1996). Since approximately 5 years, intensity modulated radiation
%U http://www.ro-journal.com/content/1/1/40