title: Concurrent chemoradiotherapy with helical tomotherapy for oropharyngeal cancer: a preliminary result.
abstract: OBJECTIVE
  To review the experience with and evaluate the treatment plan for helical tomotherapy for the treatment of oropharyngeal cancer.
  
  
  METHODS
  Between November 1, 2006 and January 31, 2009, 10 histologically confirmed oropharyngeal cancer patients were enrolled. All patients received definitive concurrent chemoradiation with helical tomotherapy. The prescription dose to the gross tumor planning target volume, the high-risk subclinical area, and the low-risk subclinical area was 70 Gy, 63 Gy, and 56 Gy, respectively. During radiotherapy, all patients were treated with cisplatin, 30 mg/m(2), plus 5-fluorouracil (425 mg/m(2))/leucovorin (30 mg/m(2)) intravenously weekly. Toxicity of treatment was scored according to the Common Terminology Criteria for Adverse Events, version 3.0. Several parameters, including maximal or median dose to critical organs, uniformity index, and conformal index, were evaluated from dose-volume histograms.
  
  
  RESULTS
  The mean survival was 18 months (range, 7-22 months). The actuarial overall survival, disease-free survival, locoregional control, and distant metastasis-free rates at 18 months were 67%, 70%, 80%, and 100%, respectively. The average for uniformity index and conformal index was 1.05 and 1.26, respectively. The mean of median dose for right side and left side parotid glands was 23.5 and 23.9 Gy, respectively. No Grade 3 toxicity for dermatitis and body weight loss and only one instance of Grade 3 mucositis were noted.
  
  
  CONCLUSIONS
  Helical tomotherapy achieved encouraging clinical outcomes in patients with oropharyngeal carcinoma. Treatment toxicity was acceptable, even in the setting of concurrent chemotherapy. Long-term follow-up is needed to confirm these preliminary findings.
authors.affiliation: Department of Radiation Oncology, Far Eastern Memorial Hospital, Taipei, Taiwan.
authors.forename: Pei-Wei
authors.initials: PW
authors.lastname: Shueng
authors.forename: Le-Jung
authors.initials: LJ
authors.lastname: Wu
authors.forename: Shiou-Yi
authors.initials: SY
authors.lastname: Chen
authors.forename: Chi-Huang
authors.initials: CH
authors.lastname: Hsiao
authors.forename: Hui-Ju
authors.initials: HJ
authors.lastname: Tien
authors.forename: Po-Wen
authors.initials: PW
authors.lastname: Cheng
authors.forename: Ying-Shiung
authors.initials: YS
authors.lastname: Kuo
authors.forename: Yu-Jen
authors.initials: YJ
authors.lastname: Chen
authors.forename: Chien-An
authors.initials: CA
authors.lastname: Chen
authors.forename: Pei-Ying
authors.initials: PY
authors.lastname: Hsieh
authors.forename: Chen-Hsi
authors.initials: CH
authors.lastname: Hsieh
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy / Q000379:methods; D018572:Disease-Free Survival; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009959:Oropharyngeal Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D010306:Parotid Gland / Q000528:radiation effects; D011855:Radiodermatitis / Q000473:pathology; D011879:Radiotherapy Dosage; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects / Q000379:methods*; D013280:Stomatitis / Q000473:pathology; D047368:Tumor Burden
chemical_list: D002945:Cisplatin; D002955:Leucovorin; D005472:Fluorouracil