{"id":6230,"date":"2020-10-09T13:09:06","date_gmt":"2020-10-09T12:09:06","guid":{"rendered":"https:\/\/www.library.sath.nhs.uk\/research\/?p=6230"},"modified":"2021-07-01T10:45:42","modified_gmt":"2021-07-01T09:45:42","slug":"results-of-a-randomized-phase-iii-study-of-dysphagia-optimized-intensity-modulated-radiotherapy-do-imrt-versus-standard-imrt-s-imrt-in-head-and-neck-cancer-2020","status":"publish","type":"post","link":"https:\/\/www.library.sath.nhs.uk\/research\/2020\/10\/09\/results-of-a-randomized-phase-iii-study-of-dysphagia-optimized-intensity-modulated-radiotherapy-do-imrt-versus-standard-imrt-s-imrt-in-head-and-neck-cancer-2020\/","title":{"rendered":"Results of a randomized phase III study of dysphagia-optimized intensity modulated radiotherapy (Do-IMRT) versus standard IMRT (S-IMRT) in head and neck cancer (2020)"},"content":{"rendered":"

Type of publication:<\/strong>
\nConference abstract<\/p>\n

Author(s):<\/strong>
\nNutting C.; Rooney K.; Foran B.; *Pettit L.; Beasley M.; Finneran L.; Roe J.; Tyler J.; Roques T.; Cook A.; Petkar I.; Bhide S.; Srinivasan D.; Boon C.; De Winton E.; Frogley R.; Mertens K.; Emson M.; Hall E.<\/p>\n

Citation:<\/strong>
\nJournal of Clinical Oncology; 2020; vol. 38 (no. 15)<\/p>\n

Abstract:<\/strong>
\nBackground: Most newly diagnosed oro-& hypopharngeal cancers (OPC, HPC) are treated with (chemo)RT with curative intent but at the consequence of adverse effects on quality of life. CRUK\/14\/014 investigated if using Do-IMRT to reduce RT dose to the dysphagia\/aspiration related structures (DARS) improved swallowing function compared to S-IMRT. Method(s): Patients with T1-4, N0-3, M0 OPC\/HPC were randomised 1:1 to S-IMRT (65 Gray (Gy)\/30 fractions (f) to primary&nodal tumour; 54Gy\/30f to remaining pharyngeal subsite&nodal areas at risk of microscopic disease) or Do-IMRT. The volume of the superior\u2223dle pharyngeal constrictor muscle (PCM) (OPC) or inferior PCM (HPC) lying outside the high-dose target volume was set a mandatory mean dose constraint in Do-IMRT. Treatment allocation was by minimisation balanced by centre, use of induction\/concomitant chemotherapy, tumour site&AJCC stage. Primary endpoint was mean MD Anderson Dysphagia Inventory (MDADI) composite score 12 months after RT with 102 patients needed to detect a 10 point improvement (assuming S-IMRT score of 72, standard deviation (SD) 13.8; 90% power, 2-sided 5% alpha). Patients were blind to treatment allocation. Secondary endpoints included local control. Result(s): 112 patients (56 S-IMRT, 56 Do-IMRT) were randomised from 22 UK centres from 06\/2016 to 04\/2018. Mean age was 57 years; 80% were male; 97% had OPC; 90% had AJCC stage 3&4 disease; 86% had concomitant chemotherapy only, 4% induction&concomitant and 10% no chemotherapy. 111\/112 had RT doses as prescribed (1 patient died before RT). Median of the mean inferior PCM dose was S-IMRT 49.8Gy (IQR 47.1-52.4) vs. Do-IMRT 28.4Gy (21.3-37.4), p < 0.0001; superior\u2223dle PCM dose was S-IMRT 57.2Gy (56.3-58.3) vs. Do-IMRT 49.7Gy (49.4-49.9), p < 0.0001. Do-IMRT had significantly higher MDADI scores: S-IMRT 70.3 (SD 17.3) vs. Do-IMRT 77.7 (16.1), p = 0.016. 3 local recurrences (1 S-IMRT, 2 Do-IMRT) have been reported. Conclusion(s): Do-IMRT reduced RT dose to the DARS and improved patient reported swallowing function compared with S-IMRT. This is the first randomised study to demonstrate functional benefit of swallow-sparing IMRT in OPC.<\/p>\n

Link to full-text<\/a> [no password required]<\/p>\n","protected":false},"excerpt":{"rendered":"

Type of publication: Conference abstract Author(s): Nutting C.; Rooney K.; Foran B.; *Pettit L.; Beasley M.; Finneran L.; Roe J.; Tyler J.; Roques T.; Cook A.; Petkar I.; Bhide S.; Srinivasan D.; Boon C.; De Winton E.; Frogley R.; Mertens…<\/span><\/p>\n

Read more Results of a randomized phase III study of dysphagia-optimized intensity modulated radiotherapy (Do-IMRT) versus standard IMRT (S-IMRT) in head and neck cancer (2020)<\/span> ›<\/span><\/a><\/div>\n

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