title: Simultaneous integrated boost using intensity-modulated radiotherapy compared with conventional radiotherapy in patients treated with concurrent carboplatin and 5-fluorouracil for locally advanced oropharyngeal carcinoma.
abstract: OBJECTIVE
  To compare, in a retrospective study, the toxicity and efficacy of simultaneous integrated boost using intensity-modulated radiotherapy (IMRT) vs. conventional radiotherapy (CRT) in patients treated with concomitant carboplatin and 5-fluorouracil for locally advanced oropharyngeal cancer.
  
  
  METHODS
  Between January 2000 and December 2007, 249 patients were treated with definitive chemoradiation. One hundred patients had 70 Gy in 33 fractions using IMRT, and 149 received CRT at 70 Gy in 35 fractions. Overall survival, disease-free survival, and locoregional control were estimated using the Kaplan-Meier method.
  
  
  RESULTS
  Median follow-up was 42 months. Three-year actuarial rates for locoregional control, disease-free survival, and overall survival were 95.1% vs. 84.4% (p = 0.005), 85.3% vs. 69.3% (p = 0.001), and 92.1% vs. 75.2% (p < 0.001) for IMRT and CRT, respectively. The benefit of the radiotherapy regimen on outcomes was also observed with a Cox multivariate analysis. Intensity-modulated radiotherapy was associated with less acute dermatitis and less xerostomia at 6, 12, 24, and 36 months.
  
  
  CONCLUSIONS
  This study suggests that simultaneous integrated boost using IMRT is associated with favorable locoregional control and survival rates with less xerostomia and acute dermatitis than CRT when both are given concurrently with chemotherapy.
authors.affiliation: Department of Radiation Oncology, Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada. sebastien.clavel@umontreal.ca
authors.forename: Sébastien
authors.initials: S
authors.lastname: Clavel
authors.forename: David H A
authors.initials: DH
authors.lastname: Nguyen
authors.forename: Bernard
authors.initials: B
authors.lastname: Fortin
authors.forename: Philippe
authors.initials: P
authors.lastname: Després
authors.forename: Nader
authors.initials: N
authors.lastname: Khaouam
authors.forename: David
authors.initials: D
authors.lastname: Donath
authors.forename: Denis
authors.initials: D
authors.lastname: Soulières
authors.forename: Louis
authors.initials: L
authors.lastname: Guertin
authors.forename: Phuc Felix
authors.initials: PF
authors.lastname: Nguyen-Tan
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D016190:Carboplatin / Q000008:administration & dosage; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D059248:Chemoradiotherapy / Q000009:adverse effects / Q000379:methods; D018572:Disease-Free Survival; D019583:Dose Fractionation, Radiation; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009959:Oropharyngeal Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies
chemical_list: D016190:Carboplatin; D005472:Fluorouracil