title: Disease-control rates following intensity-modulated radiation therapy for small primary oropharyngeal carcinoma.
abstract: BACKGROUND
  The purpose of this study was to assess the ability of intensity-modulated radiation therapy (IMRT) to achieve favorable disease-control rates while minimizing parotid gland doses in patients treated for small primary tumors of the oropharynx.
  
  
  METHODS
  We retrospectively identified all patients who received IMRT as treatment for a small (<4 cm) primary tumor of the oropharynx between October 2000 and June 2002. Tumor characteristics, IMRT parameters, and patient outcomes were assessed.
  
  
  RESULTS
  Fifty-one patients met the criteria for our study. All patients had treatment to gross disease with margin (CTV1), and all but 1 had treatment to the bilateral necks. The most common treatment schedule (39 patients) was a once-daily fractionation of prescribed doses of 63-66 Gy to the CTV1 and 54 Gy to subclinical sites, delivered in 30 fractions. Twenty-one patients (40%) had gastrostomy tubes placed during therapy; in 4 patients, the tube remained in place for more than 6 months after completion of IMRT. The median follow-up was 45 months. The 2-year actuarial locoregional control, recurrence-free, and overall survival rates were 94%, 88%, and 94%, respectively.
  
  
  CONCLUSIONS
  These preliminary data suggest that treatment with IMRT results in favorable locoregional control of small primary oropharynx tumors. IMRT did not appear to have a more favorable acute toxicity profile in this group with respect to the use of a feeding tube; however, the mean dose of radiation delivered to the parotid gland by IMRT was decreased, because 95% of patients had a mean dose of <30 Gy to at least one gland.
authors.affiliation: Division of Radiation Oncology, The University of Texas M D Anderson Cancer Center, Houston, TX 77030, USA. agarden@mdanderson.org
authors.forename: Adam S
authors.initials: AS
authors.lastname: Garden
authors.forename: William H
authors.initials: WH
authors.lastname: Morrison
authors.forename: Pei-Fong
authors.initials: PF
authors.lastname: Wong
authors.forename: Sam S
authors.initials: SS
authors.lastname: Tung
authors.forename: David I
authors.initials: DI
authors.lastname: Rosenthal
authors.forename: Lei
authors.initials: L
authors.lastname: Dong
authors.forename: Brian
authors.initials: B
authors.lastname: Mason
authors.forename: George H
authors.initials: GH
authors.lastname: Perkins
authors.forename: K Kian
authors.initials: KK
authors.lastname: Ang
mesh_terms: D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D003131:Combined Modality Therapy / Q000379:methods; D018572:Disease-Free Survival; D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009959:Oropharyngeal Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D010306:Parotid Gland / Q000528:radiation effects*; D011832:Radiation Injuries / Q000517:prevention & control*; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome