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 IJCM  Vol.9 No.9 , September 2018
Intensity Modulated Radiotherapy (IMRT) in the Planning of Hypofractionated Treatment in Head and Neck Tumors
Abstract: Head and neck cancer (HNCC) is the sixth most common cancer with an incidence of approximately 600,000 cases per year and 300,000 annual deaths worldwide1y2. In Cuba, cancer of the larynx is the fourth cause in incidence, being the fourth cause of cancer death in men. Radiotherapy constitutes an important modality in the control of these tumors and the Intensity Modulated Radiotherapy (IMRT) is a new advance in this field. With it, it is possible to improve dose distribution, decreasing the dose in adjacent healthy tissues and escalating dose in tumor. In this work we present 33 patients of National Institute of Oncology and Radiobiology in Cuba (INOR), in whom the IMRT was used as a treatment technique with a hypofractionation of the dose. Their response was observed at the end of the treatment and one month later. 56% (19) of the patients had a complete response to treatment at the primary site of the tumor and neck. 10% (3) had no response, progressed. 11 of the patients had no response at the lymph node site at the end of treatment, 8 of these 11 had complete remission one month after radiotherapy ended.
Cite this paper: Morales, M. and Moreno, R. (2018) Intensity Modulated Radiotherapy (IMRT) in the Planning of Hypofractionated Treatment in Head and Neck Tumors. International Journal of Clinical Medicine, 9, 675-683. doi: 10.4236/ijcm.2018.99056.
References

[1]   Sigel, R., Naishadham, D. and Jemal, A. (2013) Cancer Statistics 2013. CA: A Cancer Journal for Clinicians, 63, 11-30.
https://doi.org/10.3322/caac.21166

[2]   Boyle, P. and Levin, B. (2008) World Cancer Report 2008. International Agency for Research on Cancer, Lyon,

[3]   NU. CEPAL. Statistics Division (2017) Cuba's Statistical Yearbook for Latinoamerican and the Caribbean.
http://interwp.cepal.org/anuario_estadistico/Anuario_2017/index-en.htm

[4]   Sigel, R., Naishadham, D. and Jemal, A. (2014) Cancerstatistics 2014. CA: A Cancer Journal for Clinicians, 64, 9-29.

[5]   Eugenio Vinés, V., María José Orellana, G., Catalina Bravo, M. and David Jofré, P. (2017) Manejo del cáncer de cabeza y cuello: ¿Radioterapia a quién, cuándo y por qué? Revista de otorrinolaringología y cirugía de cabeza y cuello, 77, 81-90.

[6]   Thariat, J., Hannoun-Levi, J.M., Myint, A.S., et al. (2013) Past, Present and Future of Radiotherapy for the Benefitof Patients. Nature Reviews Clinical Oncology, 10, 52.
https://doi.org/10.1038/nrclinonc.2012.203

[7]   Wang, J.S. and Eisbruch, A. (2016) IMRT for Head and Neckcancer: Reducing Xerostomia and Dysphagia. Journal of Radiation Research, 57, 169-175.
https://doi.org/10.1093/jrr/rrw047

[8]   Bentzen, S.M. (2005) Radiation Therapy: Intensity Modulated, Image Guided Biologically Optimized and Evidence Based. Radiotherapy and Oncology, 77, 227-230.
https://doi.org/10.1016/j.radonc.2005.11.001

[9]   Filippi, A.R., Vanoni, V. and Meduri, B., et al. (2018) Intensity Modulated Radiation Therapy and Second Cancer Risk in Adults. International Journal of Radiation Oncology, Biology, Physics, 100, 17-20.
https://doi.org/10.1016/j.ijrobp.2017.09.039

[10]   Chao, K.S., Ozyigit, G., Blanco, A.I., Thorstad, W.L., Deasy, J.O., Haughey, B.H., Spector, G.J. and Sessions, D.G. (2004) Intensity-Modulated Radiation Therapy Ororopharyngeal Carcinoma: Impact of Tumor Volume. International Journal of Radiation Oncology, Biology, Physics, 59, 43-50.
https://doi.org/10.1016/j.ijrobp.2003.08.004

[11]   Dawson, L.A., Anzai, Y., Marsh, L., Martel, M.K., Paulino, A., Ship, J.A. and Eisbruch, A. (2000) Patterns of Local-Regional Recurrence Following Parotid-Sparingconformal and Segmental Intensity-Modulated Radiotherapy for Head and Neck Cancer. International Journal of Radiation Oncology, Biology, Physics, 46, 1117-1126.
https://doi.org/10.1016/S0360-3016(99)00550-7

[12]   Butler, E.B., Teh, B.S., Grant III, W.H., Uhl, B.M., Kuppersmith, R.B., Chiu, J.K., Donovan, D.T. and Woo, S.Y. (1999) Smart (Simultaneous Modulated Acceleratedradiation Therapy) Boost: A New Accelerated Fractionation Schedulefor the Treatment of Head and Neck Cancer with Intensity Modulated. Radiotherapy. International Journal of Radiation Oncology, Biology, Physics, 45, 21-32.
https://doi.org/10.1016/S0360-3016(99)00101-7

[13]   Corvò, R. (2007) Evidence-Based Radiation Oncology in Head and Neck Squamous Cell Carcinoma. Radiotherapy and Oncology, 85, 156-170.
https://doi.org/10.1016/j.radonc.2007.04.002

[14]   Di Nicola, L., Gravina, G.L., Marampon, F., Bonfili, P., Buonopane, S., Di Staso, M., et al. (2010) The Impact of Conventional or Hypofractionated Radiotherapy on Voice Quality and Oncological Outcome in Patients with Early. Glotticcancer. Oncology Reports, 24, 1383-1388.

[15]   Roy, S., Mallik, C., Ghorai, S., Hazra, A. and Majumdar, A. (2015) Hypofractionated versus Conventional Radiotherapy with or without Chemotherapy in Head and Neck Cancer: A Comparative Study. Clinical Cancer Investigation Journal, 4, 140-146.
https://doi.org/10.4103/2278-0513.152718

[16]   Bourhis, J., Overgaard, J., Audry, H., Ang, K.K., Saunders, M., Bernier, J., et al. (2006) Hyperfractionated or Accelerated Radiotherapy in Head and Neck Cancer: A Meta-Analysis. The Lancet, 368, 843-854.
https://doi.org/10.1016/S0140-6736(06)69121-6

[17]   Sanghera, P., McConkey, C., Ho, K.F., Glaholm, J. and Hartley, A. (2007) Hypofractionated Accelerated Radiotherapy with Concurrent Chemotherapy for Locally Advanced Squamous Cell Carcinoma of the Head and Neck. International Journal of Radiation Oncology, Biology, Physics, 67, 1342-1351.
https://doi.org/10.1016/j.ijrobp.2006.11.015

[18]   Eisbruch, A., Harris, J., Garden, A.S., Chao, C.K., Straube, W., Harari, P.M., et al. (2010) Multi-Institutional Trial of Accelerated Hypofractionated Intensity-Modulated Radiation Therapy for Early-Stage Oropharyngeal Cancer (RTOG 00-22). International Journal of Radiation Oncology, Biology, Physics, 76, 1333-1338.
https://doi.org/10.1016/j.ijrobp.2009.04.011

[19]   Lauve, A., Morris, M., Schmidt-Ullrich, R., Wu, Q., Mohan, R., Abayomi, O., et al. (2004) Simultaneous Integrated Boost Intensity-Modulated Radiotherapy for Locally Advanced Head-and-Neck Squamous Cell Carcinomas: II Clinical Results. International Journal of Radiation Oncology, Biology, Physics, 60, 374-387.
https://doi.org/10.1016/j.ijrobp.2004.03.010

[20]   Weissberg, J.B., Pillsbury, H., Sasaki, C.T., Son, Y.H. and Fischer, J.J. (1983) High Fractional Dose Irradiation of Advanced Head and Neck Cancer. Implications for Combined Radiotherapy and Surgery. Archives of Otolaryngology, 109, 98-102.
https://doi.org/10.1001/archotol.1983.00800160032008

[21]   Das, S., Thomas, S., Pal, S.K., Isiah, R., John, S., et al. (2013) Hypofractionated Palliative Radiotherapy in Locally Advanced Inoperable Head and Neck Cancer: CMC Vellore Experience. Indian Journal of Palliative Care, 19, 93-98.
https://doi.org/10.4103/0973-1075.116709

 
 
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