PMID- 35000532
OWN - NLM
STAT- MEDLINE
DCOM- 20220204
LR  - 20220430
IS  - 1651-226X (Electronic)
IS  - 0284-186X (Linking)
VI  - 61
IP  - 2
DP  - 2022 Feb
TI  - Swallowing sparing intensity modulated radiotherapy versus standard parotid 
      sparing intensity-modulated radiotherapy for treatment of head and neck cancer: a 
      randomized clinical trial.
PG  - 134-140
LID - 10.1080/0284186X.2021.2022198 [doi]
AB  - BACKGROUND: Dysphagia is a distressing symptom during and after radiotherapy 
      treatment in head and neck cancer (HNC) patients. The objective of this 
      prospective study was to investigate whether swallowing sparing intensity 
      modulated radiotherapy (SW-IMRT) reduces the occurrence of swallowing dysfunction 
      compared to the standard IMRT (ST-IMRT). METHODS: We randomized, planned, and 
      treated patients with HNC who needed whole neck irradiation using the 
      simultaneous integrated boost (SIB) IMRT technique. Doses of 70, 60, and 54 Gy 
      (over 33 daily fractions) were prescribed to the primary tumor, high-risk and 
      low-risk regions, respectively. The postoperative cases received 60 and 54 Gy 
      (over 30 daily fractions) to the high-risk planning target volume (PTV) and 
      low-risk PTV. We contoured organs at risk related to swallowing dysfunction 
      (SWOARs) in all cases. In the ST-IMRT group, parotids only were spared. In the 
      SW-IMRT group, parotids and SWOARs outside the high-risk PTV were spared. 
      Assessment of dysphagia included clinical and instrumental evaluation. RESULTS: 
      One hundred forty-six patients ended their radiotherapy treatment. Dose 
      distribution showed comparable PTV coverage and no difference in parotid glands 
      sparing between the two groups. SWOARs dose reduction with SW-IMRT differs 
      according to tumor location and its overlap with SWOARs. Using different 
      assessment methods, SW-IMRT was associated with a lower occurrence of dysphagia 
      up to one year after treatment. There was no difference between the two groups 
      regarding acute dysphagia (p = 0.262), overall survival (p = 0.811), and 
      disease-free survival (p = 0.876). CONCLUSION: SW-IMRT is significantly better 
      than ST-IMRT regarding a physician-rated and objective assessment of swallowing 
      dysfunction at short- and long-term post-treatment follow-up.
FAU - Ashour, May Gamal
AU  - Ashour MG
AUID- ORCID: 0000-0002-9495-5937
AD  - Radiation Oncology Department, National Cancer Institute Cairo University, Cairo, 
      Egypt.
FAU - Shouman, Tarek Hamed
AU  - Shouman TH
AD  - Radiation Oncology Department, National Cancer Institute Cairo University, Cairo, 
      Egypt.
FAU - Hassouna, Ashraf Hamed
AU  - Hassouna AH
AD  - Radiation Oncology Department, National Cancer Institute Cairo University, Cairo, 
      Egypt.
FAU - Mokhtar, Maha Hassan
AU  - Mokhtar MH
AD  - Physics Unit, National Cancer Institute Cairo University, Cairo, Egypt.
FAU - Emad El Din, Reem
AU  - Emad El Din R
AUID- ORCID: 0000-0003-3457-8735
AD  - Radiation Oncology Department, National Cancer Institute Cairo University, Cairo, 
      Egypt.
FAU - Youssef, Ayda Aly
AU  - Youssef AA
AD  - Radiology Department, National Cancer Institute Cairo University, Cairo, Egypt.
FAU - Gomaa, Mohammed Mohammed
AU  - Gomaa MM
AUID- ORCID: 0000-0003-1670-8532
AD  - Radiology Department, National Cancer Institute Cairo University, Cairo, Egypt.
FAU - Abdelgeleel, Shaimaa
AU  - Abdelgeleel S
AUID- ORCID: 0000-0003-0994-7703
AD  - Statistics Department, National Cancer Institute Cairo University, Cairo, Egypt.
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20220109
PL  - Sweden
TA  - Acta Oncol
JT  - Acta oncologica (Stockholm, Sweden)
JID - 8709065
SB  - IM
MH  - Deglutition
MH  - *Head and Neck Neoplasms/radiotherapy
MH  - Humans
MH  - Parotid Gland
MH  - Prospective Studies
MH  - Radiotherapy Dosage
MH  - Radiotherapy Planning, Computer-Assisted
MH  - *Radiotherapy, Intensity-Modulated/adverse effects
OTO - NOTNLM
OT  - Head and neck cancer
OT  - ST-IMRT
OT  - SW-IMRT
OT  - SWOARs
OT  - dysphagia
EDAT- 2022/01/11 06:00
MHDA- 2022/02/05 06:00
CRDT- 2022/01/10 05:37
PHST- 2022/01/11 06:00 [pubmed]
PHST- 2022/02/05 06:00 [medline]
PHST- 2022/01/10 05:37 [entrez]
AID - 10.1080/0284186X.2021.2022198 [doi]
PST - ppublish
SO  - Acta Oncol. 2022 Feb;61(2):134-140. doi: 10.1080/0284186X.2021.2022198. Epub 2022 
      Jan 9.