title: Change in the Quality of Life in Oropharyngeal, Laryngeal and Hypopharyngeal Cancer Patients treated with Volumetric Modulated Arc-Based Concomitant Boost Radiotherapy.
abstract: OBJECTIVE
  To assess the change in the quality of life (QOL) in Oropharyngeal, Laryngeal and Hypopharyngeal cancer patients treated with concomitant boost radiotherapy by Volumetric Intensity Modulated Arc Therapy (VMAT) technique.
  
  
  METHODS
  Thirty patients with oropharynx, larynx or hypopharynx cancers of stage II to IVA were treated with an Accelerated fractionation schedule using Concomitant boost. The dose given was 1.8Gy/fraction daily, 5 days a week to the large field for 28 fractions and a daily concomitant boost of 1.5Gy/fraction to the boost field over the last 12 treatment days for a total dose of 68.4Gy/40 fractions/5½weeks by VMAT technique with concurrent chemotherapy (in stage III and IV patients) using Cisplatin 100mg/m2 IV three weekly during week 1 and week 4 of irradiation. QOL was assessed using the European Organization of Research and Treatment of Cancer Quality of Life Core Questionnaire, version 3.0 (EORTC QLQC30) and EORTC head and neck module (EORTC QLQ-HN35) before treatment, at the end of treatment, 1 month, 3 months and 6 months post treatment. The QOL scores and their evolution over the five measurements were calculated.
  
  
  RESULTS
  The change in the QOL scores was acceptable in general. There was a significant reduction in quality of life scores at the end of treatment. The QOL improved in the followup period; and by 3 months post irradiation, there was a return of QOL scores to the baseline value.
  
  
  CONCLUSIONS
  The QOL scores indicate that concomitant boost radiotherapy by VMAT is well tolerated and helps in rapid return to baseline quality of life scores. We believe that this is one of the first papers which have combined concomitant boost radiotherapy with VMAT technique in head and neck cancers. VMAT based concomitant boost radiotherapy helps in rapid return to baseline quality of life.
authors.affiliation: Department of Radiotherapy, JIPMER, Puducherry, India.
authors.forename: P
authors.initials: P
authors.lastname: Kannan
authors.affiliation: Department of Radiotherapy, JIPMER, Puducherry, India.
authors.forename: A
authors.initials: A
authors.lastname: Mukherji
authors.affiliation: Department of Radiotherapy, JIPMER, Puducherry, India.
authors.forename: K
authors.initials: K
authors.lastname: Saravanan
authors.affiliation: Department of Oncology, Mahatma Gandhi Medical College and Research Centre, Puducherry, India.
authors.forename: K S
authors.initials: KS
authors.lastname: Reddy
authors.affiliation: Department of Radiotherapy, JIPMER, Puducherry, India.
authors.forename: S
authors.initials: S
authors.lastname: Vivekanandam
authors.affiliation: Malabar Institute of Medical Sciences, Kozhikode, Kerala, India.
authors.forename: C
authors.initials: C
authors.lastname: Shamsudheen
authors.affiliation: Kailash Cancer Hospital and Research Institute, Vadodara, Gujarat, India.
authors.forename: V
authors.initials: V
authors.lastname: Santhosh
mesh_terms: D006258:Head and Neck Neoplasms / Q000523:psychology* / Q000532:radiotherapy*; D006801:Humans; D007012:Hypopharyngeal Neoplasms; D011788:Quality of Life; D011879:Radiotherapy Dosage; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods; D016896:Treatment Outcome
keywords: Head and neck cancers; IMRT; altered fractionation; concomitant boost radiotherapy; head and neck cancers.; quality of life; volumetric arc therapy in head and cancers