title: Acute toxicities experienced during simultaneous integrated boost intensity-modulated radiotherapy in head and neck cancers--experience from a north Indian regional cancer centre.
abstract: OBJECTIVE
  A prospective study was conducted to assess the feasibility of simultaneous integrated boost intensity-modulated radiotherapy (SIB IMRT) in our setting. Acute toxicities encountered during and immediately after treatment are reported.
  
  
  METHODS
  Acute toxicity data prospectively collected during the treatment of the evaluable 28 patients with two SIB IMRT schedules were analysed. Toxicity was graded using the Common Terminology Criteria for Adverse Events version 3.0 system. Twenty-one patients were treated with the SIB72 schedule, delivering 72, 66 and 57 Gy in 33 fractions to the gross tumour volume, the high-risk clinical target volume and the low-risk clinical target volume, respectively, whereas seven patients were treated with the SIB66 schedule, delivering 66, 60 and 54 Gy in 30 fractions to the above volumes. No chemotherapy was given during the course of treatment. Descriptive analysis of the incidence and actuarial analysis of the duration of toxicities are presented.
  
  
  RESULTS
  Grade 3 or greater acute mucosal and actinic toxicity were seen 42.9 and 14.3% of the patients, respectively. Mucosal toxicity appeared by the second week in most patients. Atypical patterns of mucositis were encountered, including one patient with prolonged grade 4 mucosal ulceration in the SIB72 schedule. Grade 3 weight loss was seen in 10.57% of patients. Grade 3 pain was seen in 70% and grade 3 dysphagia in 10% during treatment.
  
  
  CONCLUSIONS
  SIB IMRT as used in this study was feasible, although associated with increased rates of mucosal and dermal toxicity.
authors.affiliation: Department of Radiotherapy and Oncology, Post Graduate Institute of Medical Education and Research, Chandigarh, India. drsantam@gmail.com
authors.forename: S
authors.initials: S
authors.lastname: Chakraborty
authors.forename: S
authors.initials: S
authors.lastname: Ghoshal
authors.forename: V
authors.initials: V
authors.lastname: Patil
authors.forename: A
authors.initials: A
authors.lastname: Oinam
authors.forename: S
authors.initials: S
authors.lastname: Suresh
mesh_terms: D000206:Actuarial Analysis; D000328:Adult; D000368:Aged; D004307:Dose-Response Relationship, Radiation; D005260:Female; D006258:Head and Neck Neoplasms / Q000150:complications / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D015994:Incidence; D007194:India; D017567:Karnofsky Performance Status; D008297:Male; D008875:Middle Aged; D052016:Mucositis / Q000150:complications / Q000209:etiology* / Q000473:pathology; D011446:Prospective Studies; D011832:Radiation Injuries / Q000209:etiology* / Q000473:pathology; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000009:adverse effects; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects*; D016896:Treatment Outcome