PMID- 19540060
OWN - NLM
STAT- MEDLINE
DCOM- 20100414
LR  - 20220317
IS  - 1879-355X (Electronic)
IS  - 0360-3016 (Print)
IS  - 0360-3016 (Linking)
VI  - 76
IP  - 5
DP  - 2010 Apr
TI  - Multi-institutional trial of accelerated hypofractionated intensity-modulated 
      radiation therapy for early-stage oropharyngeal cancer (RTOG 00-22).
PG  - 1333-8
LID - 10.1016/j.ijrobp.2009.04.011 [doi]
AB  - PURPOSE: To assess the results of a multi-institutional study of 
      intensity-modulated radiation therapy (IMRT) for early oropharyngeal cancer. 
      PATIENTS AND METHODS: Patients with oropharyngeal carcinoma Stage T1-2, N0-1, M0 
      requiring treatment of the bilateral neck were eligible. Chemotherapy was not 
      permitted. Prescribed planning target volumes (PTVs) doses to primary tumor and 
      involved nodes was 66 Gy at 2.2 Gy/fraction over 6 weeks. Subclinical PTVs 
      received simultaneously 54-60 Gy at 1.8-2.0 Gy/fraction. Participating 
      institutions were preapproved for IMRT, and quality assurance review was 
      performed by the Image-Guided Therapy Center. RESULTS: 69 patients were accrued 
      from 14 institutions. At median follow-up for surviving patients (2.8 years), the 
      2-year estimated local-regional failure (LRF) rate was 9%. 2/4 patients (50%) 
      with major underdose deviations had LRF compared with 3/49 (6%) without such 
      deviations (p = 0.04). All cases of LRF, metastasis, or second primary cancer 
      occurred among patients who were current/former smokers, and none among patients 
      who never smoked. Maximal late toxicities Grade >or=2 were skin 12%, mucosa 24%, 
      salivary 67%, esophagus 19%, osteoradionecrosis 6%. Longer follow-up revealed 
      reduced late toxicity in all categories. Xerostomia Grade >or=2 was observed in 
      55% of patients at 6 months but reduced to 25% and 16% at 12 and 24 months, 
      respectively. In contrast, salivary output did not recover over time. 
      CONCLUSIONS: Moderately accelerated hypofractionatd IMRT without chemotherapy for 
      early oropharyngeal cancer is feasible, achieving high tumor control rates and 
      reduced salivary toxicity compared with similar patients in previous Radiation 
      Therapy Oncology Group studies. Major target underdose deviations were associated 
      with higher LRF rate.
FAU - Eisbruch, Avraham
AU  - Eisbruch A
AD  - Department of Radiation Oncology, University of Michigan, Ann Arbor, MI 48109, 
      USA. eisbruch@umich.edu
FAU - Harris, Jonathan
AU  - Harris J
FAU - Garden, Adam S
AU  - Garden AS
FAU - Chao, Clifford K S
AU  - Chao CK
FAU - Straube, William
AU  - Straube W
FAU - Harari, Paul M
AU  - Harari PM
FAU - Sanguineti, Giuseppe
AU  - Sanguineti G
FAU - Jones, Christopher U
AU  - Jones CU
FAU - Bosch, Walter R
AU  - Bosch WR
FAU - Ang, K Kian
AU  - Ang KK
LA  - eng
GR  - U24 CA081647/CA/NCI NIH HHS/United States
GR  - CCOP U10 CA37422/CA/NCI NIH HHS/United States
GR  - RTOG U10 CA21661/CA/NCI NIH HHS/United States
GR  - U10 CA037422/CA/NCI NIH HHS/United States
GR  - U10 CA021661/CA/NCI NIH HHS/United States
GR  - ATC U24 CA81647/CA/NCI NIH HHS/United States
GR  - U10 CA021661-32S4/CA/NCI NIH HHS/United States
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, N.I.H., Extramural
DEP - 20090618
PL  - United States
TA  - Int J Radiat Oncol Biol Phys
JT  - International journal of radiation oncology, biology, physics
JID - 7603616
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Carcinoma, Squamous Cell/pathology/*radiotherapy
MH  - Dose Fractionation, Radiation
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Neoplasms, Second Primary
MH  - Oropharyngeal Neoplasms/pathology/*radiotherapy
MH  - Quality Control
MH  - Radiation Injuries/pathology
MH  - Radiotherapy, Intensity-Modulated/*methods/standards
MH  - Tumor Burden
PMC - PMC2846217
MID - NIHMS113223
COIS- Conflict of Interest: None
EDAT- 2009/06/23 09:00
MHDA- 2010/04/15 06:00
PMCR- 2011/04/01
CRDT- 2009/06/23 09:00
PHST- 2009/02/18 00:00 [received]
PHST- 2009/04/03 00:00 [revised]
PHST- 2009/04/07 00:00 [accepted]
PHST- 2009/06/23 09:00 [entrez]
PHST- 2009/06/23 09:00 [pubmed]
PHST- 2010/04/15 06:00 [medline]
PHST- 2011/04/01 00:00 [pmc-release]
AID - S0360-3016(09)00558-6 [pii]
AID - 10.1016/j.ijrobp.2009.04.011 [doi]
PST - ppublish
SO  - Int J Radiat Oncol Biol Phys. 2010 Apr;76(5):1333-8. doi: 
      10.1016/j.ijrobp.2009.04.011. Epub 2009 Jun 18.