Effect of hypofractionated intensity-modulated radiation therapy on acute toxicities for locally advanced squamous cell carcinoma of the hypopharynx / 中国肿瘤临床

ABSTRACT

Objective: To evaluate the feasibility of hypofractionated intensity-modulated radiation therapy (IMRT) combined with concurrent chemotherapy in patients with locally advanced squamous cell carcinoma of the hypopharynx. Methods:Patients with stageⅢ-ⅣA carcinoma of the hypopharynx were treated with IMRT and cisplatin-based concurrent chemotherapy. Two groups were di-vided according to the prescription dose to the primary gross tumor volume, as followsCohort-1 comprised patients who were recruit-ed before February 2013 (70 Gy/33 F and 2.12 Gy/F);and Cohort-2 comprised patients who were recruited since February 2013 (69 Gy/30 F and 2.30 Gy/F). Acute toxicities were evaluated. This study was registered with the number ChiCTR-ONRC-14004240. Results:Between August 2008 and December 2014, a total of 76 patients (35 in Cohort-1 and 41 in Cohort-2) were recruited. No xerostomia of grade 3 and higher was observed in all patients, who showed low incidences of grade 3 skin reaction, oral mucositis, and dysphagia. All patients did not show acute toxicities of higher than grade 4. No statistical differences in acute toxicities were observed between the two cohorts. No statistical difference was observed in acute toxicities between the IMRT techniques. Induction chemotherapy was the inde-pendent prognostic factor for grade 2 xerostomia (P=0.002). Conclusion:The 69 Gy/30 F hypofractionated IMRT was safe and effec-tive in the treatment of locally advanced squamous cell carcinoma of the hypopharynx. Late toxicities and long-term outcome need to be investigated further.