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Title

Treatment outcomes of (chemo) radiotherapy for oropharyngeal cancers: influence of the use of 15 MV X-rays in radiation boost

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 Start Page 257 | End Page 267

Abstract

 Background: Using high energy X-rays (>10 MV) as a radiotherapy boost in trea ng Oropharyngeal cancers (OPC) to reduce mandible radia on exposure may result in deteriora on of disease control rates due to re-build-up of X-rays at the tumor surface. Therefore, we retrospec vely compared the treatment outcomes and toxici es in OPC pa ents treated with radiotherapy using 15 MV and/or 4– 6 MV Xrays as a boost. Materials and Methods: Between 2008 and 2014, 63 OPC pa ents received defini ve 3-dimensional conformal radiotherapy. The median total dose was 70. 2 (range, 46. 8– 75. 6) Gy. The median follow-up period for surviving pa ents was 48 (range, 9– 88) months. Twenty-one pa ents (33. 3%) received a boost employing 15 MV X-ray in at least one beam during treatment, and 42 pa ents (66. 7%) received only 4– 6 MV X-rays. Local control (LC), locoregional control (LRC), disease-free survival (DFS), overall survival (OS) rates and the incidence of osteoradionecrosis (ORN) in the mandible for the two cohorts were es mated using the Kaplan-Meier method and compared using the log-rank test. Results: There were no sta s cally significant differences between the two cohorts in either treatment outcomes (3-year LC, 81% versus 75% [p=0. 742]; 3-year LRC, 71% versus 71% [p=0. 925]; 3-year DFS, 66% versus 66% [p=0. 934]; 3-year OS, 65% versus 78% [p=0. 321]) or incidence of grade >2 ORN in the mandible (9. 5% versus 11. 9% [p=0. 883]). Conclusion: Employing 15 MV X-rays in a boost may provide comparable treatment outcomes to 4– 6 MV X-rays. However, reduc on in the incidence of ORN in the mandible was not demonstrated.

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