title: Outcomes of intensity-modulated radiotherapy versus conventional radiotherapy for hypopharyngeal cancer.
abstract: BACKGROUND
  The purpose of this study was to discuss if the adoption of intensity-modulated radiotherapy (IMRT) for hypopharyngeal squamous cell carcinoma (SCC) has improved the outcome.
  
  
  METHODS
  We compared 3-dimensional (3D) radiotherapy (RT) and IMRT in all patients with hypopharyngeal SCC treated with curative intent RT or chemoradiation therapy (CRT) from January 1, 2000, to February 28, 2010. Locoregional control, overall survival (OS), distant relapse rate, larynx preservation rate, and enteral feeding tube duration were analyzed.
  
  
  RESULTS
  Of 181 consecutive patients, 90 received 3D-RT and 91 received IMRT. At 3 years, the IMRT group had higher locoregional control compared with the 3D-RT group (75% vs 58%; p = .003), but similar OS (50% vs 52%; p = .99), distant relapse rate (23% vs 20%; p = .79), and larynx-preservation rate (90% vs 86%; p = .16). The 2-year enteral feeding tube dependency rate was similar in both groups (19% vs 18%; p = .12).
  
  
  CONCLUSIONS
  Patients with hypopharyngeal SCC treated with IMRT showed a higher locoregional control compared with 3D-RT. However, distant-relapse rate and OS remain comparable between treatment techniques.
authors.affiliation: Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Gary
authors.initials: G
authors.lastname: Mok
authors.forename: Isabelle
authors.initials: I
authors.lastname: Gauthier
authors.forename: Haiyan
authors.initials: H
authors.lastname: Jiang
authors.forename: Shao Hui
authors.initials: SH
authors.lastname: Huang
authors.forename: Kelvin
authors.initials: K
authors.lastname: Chan
authors.forename: Ian J
authors.initials: IJ
authors.lastname: Witterick
authors.forename: Brian
authors.initials: B
authors.lastname: O'Sullivan
authors.forename: John N
authors.initials: JN
authors.lastname: Waldron
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Bayley
authors.forename: B C John
authors.initials: BC
authors.lastname: Cho
authors.forename: Bernard J
authors.initials: BJ
authors.lastname: Cummings
authors.forename: Laura A
authors.initials: LA
authors.lastname: Dawson
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Hope
authors.forename: John J
authors.initials: JJ
authors.lastname: Kim
authors.forename: Jolie
authors.initials: J
authors.lastname: Ringash
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology*; D009864:Ontario; D016016:Proportional Hazards Models; D011879:Radiotherapy Dosage; D020266:Radiotherapy, Conformal / Q000009:adverse effects / Q000379:methods*; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D018570:Risk Assessment; D000077195:Squamous Cell Carcinoma of Head and Neck; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome
keywords: 3D conformal radiotherapy; hypopharynx; intensity-modulated radiotherapy (IMRT); larynx preservation