Comparison of IMRT techniques in the radiotherapeutic management of head and neck cancer: Is tomotherapy "better" than step-and-shoot IMRT?

A. M. Chen, J. Marsano, Julian R Perks, D Gregory Farwell, Q. Luu, P. J. Donald, J. A. Purdy

Research output: Contribution to journalArticle

15 Scopus citations

Abstract

Currently, the most common method of delivering intensity-modulated radiotherapy (IMRT) is through step-and-shoot, segmental multi-leaf collimator (SMLC)-based techniques. Although rotational delivery methods such as helical tomotherapy (HT) have been proposed as offering advantages in the treatment of head and neck cancer, a lack of clinical data exists on its potential utility. This study compared dosimetric, clinical, and quality-of-life endpoints among 149 patients treated by HT and SMLC-IMRT for head and neck cancer. Dosimetric analysis revealed that the use of HT resulted in significant improvements with respect to mean dose (23.5 versus 27.9 Gy, p = 0.03) and V30 (30.1 versus 43.9 Gy, p = 0.01) to the contralateral (spared) parotid gland. However, the incidence of grade 3+ xerostomia in the late setting was 10% and 8% among patients treated by HT and SMLC-IMRT, respectively (p = 0.46). There were no significant differences in any of the quality of life endpoints among patients treated by HT and SMLC-IMRT (p > 0.05, for all). Acknowledging the biases inherent in this retrospective analysis, we found that the dosimetric advantages observed with HT compared to SMLC-IMRT failed to translate into significant improvements in clinical outcome. Prospective studies are needed to further evaluate how HT may affect the therapeutic ratio.

Original languageEnglish (US)
Pages (from-to)171-177
Number of pages7
JournalTechnology in Cancer Research and Treatment
Volume10
Issue number2
StatePublished - Apr 2011

Keywords

  • Head and neck
  • Helical tomotherapy
  • Intensity-modulated radiotherapy
  • Parotid sparing
  • Radiation planning

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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