Based on literature, intensity-modulated radiation therapy (IMRT) provides less related toxicity compared with conventional 2D/3D-RT with no impact on oncological outcomes for oropharyngeal cancer. The aim of this systematic review and meta-analysis is to assess whether IMRT might provide similar clinical outcomes with reduced related toxicity in comparison with conventional 2D/3D RT in patients treated for clinically advanced oropharyngeal cancer (OPC). Inclusion criteria for paper selection included: squamous OPC patients, treatment performed by concomitant CRT or RT alone, four treatment performed for curative intent, and presence of clinical outcome of interest, namely, overall survival (OS) and disease-free survival (DFS) and full paper available in English. Acute and late toxicities were retrieved together with OS and DFS. Crude relative risk estimates of relapse and death comparing 2D/3D-RT versus IMRT were calculated from tabular data, extracting events at 2–3 years of follow-up. Eight studies were selected. Six of them were included in the meta-analysis considering summary relative risk. Considering both acute and late toxicities, the considered studies evidenced advantages for IMRT populations, with the 2D/3D-RT population showing higher frequencies than the IMRT one. No statistical difference between IMRT and 2D/3D-RT in terms of death (SRR = 0.93, 95% CI: 0.83–1.04 with no heterogeneity I2 = 0%) and relapse (SRR = 0.92, 95% CI: 0.83–1.03, with no heterogeneity I2 = 0%) was found. Results of our study suggest the improvement in the therapeutic index with IMRT with evidenced reduced toxicity without any worsening in clinical outcome when compared to 2D/3DCRT.

IMRT versus 2D/3D conformal RT in oropharyngeal cancer: A review of the literature and meta-analysis / D. Alterio, S.G. Gugliandolo, M. Augugliaro, G. Marvaso, S. Gandini, F. Bellerba, S.W. Russell-Edu, I. De Simone, M. Cinquini, A. Starzynska, M. Zaffaroni, A. Bacigalupo, G. Fanetti, S. Durante, S. Dicuonzo, R. Orecchia, B.A. Jereczek-Fossa. - In: ORAL DISEASES. - ISSN 1354-523X. - 27:7(2021 Oct), pp. 1644-1653. [10.1111/odi.13599]

IMRT versus 2D/3D conformal RT in oropharyngeal cancer: A review of the literature and meta-analysis

Augugliaro M.;Marvaso G.;Gandini S.;Bellerba F.;Cinquini M.;Fanetti G.;Durante S.;Dicuonzo S.;Orecchia R.;Jereczek-Fossa B. A.
2021-10

Abstract

Based on literature, intensity-modulated radiation therapy (IMRT) provides less related toxicity compared with conventional 2D/3D-RT with no impact on oncological outcomes for oropharyngeal cancer. The aim of this systematic review and meta-analysis is to assess whether IMRT might provide similar clinical outcomes with reduced related toxicity in comparison with conventional 2D/3D RT in patients treated for clinically advanced oropharyngeal cancer (OPC). Inclusion criteria for paper selection included: squamous OPC patients, treatment performed by concomitant CRT or RT alone, four treatment performed for curative intent, and presence of clinical outcome of interest, namely, overall survival (OS) and disease-free survival (DFS) and full paper available in English. Acute and late toxicities were retrieved together with OS and DFS. Crude relative risk estimates of relapse and death comparing 2D/3D-RT versus IMRT were calculated from tabular data, extracting events at 2–3 years of follow-up. Eight studies were selected. Six of them were included in the meta-analysis considering summary relative risk. Considering both acute and late toxicities, the considered studies evidenced advantages for IMRT populations, with the 2D/3D-RT population showing higher frequencies than the IMRT one. No statistical difference between IMRT and 2D/3D-RT in terms of death (SRR = 0.93, 95% CI: 0.83–1.04 with no heterogeneity I2 = 0%) and relapse (SRR = 0.92, 95% CI: 0.83–1.03, with no heterogeneity I2 = 0%) was found. Results of our study suggest the improvement in the therapeutic index with IMRT with evidenced reduced toxicity without any worsening in clinical outcome when compared to 2D/3DCRT.
3D conformal radiotherapy; head and neck cancer; IMRT; oropharyngeal cancer; systematic review; Humans; Neoplasm Recurrence, Local; Treatment Outcome; Oropharyngeal Neoplasms; Radiotherapy, Conformal; Radiotherapy, Intensity-Modulated
Settore MED/36 - Diagnostica per Immagini e Radioterapia
set-2020
Article (author)
File in questo prodotto:
File Dimensione Formato  
Oral Diseases - 2020 - Alterio - IMRT versus 2D 3D conformal RT in oropharyngeal cancer A review of the literature and.pdf

non disponibili

Tipologia: Publisher's version/PDF
Dimensione 980.82 kB
Formato Adobe PDF
980.82 kB Adobe PDF   Visualizza/Apri   Richiedi una copia
Pubblicazioni consigliate

Caricamento pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/904019
Citazioni
  • ???jsp.display-item.citation.pmc??? 2
  • Scopus 2
  • ???jsp.display-item.citation.isi??? 2
social impact