Toxicity Profile of Intensity Modulated Radiotherapy Vs. 3D-Conformal Radiotherapy in Head and neck cancer: A Retrospective study

Abstract

Background : Most head and neck patients have historically been treated with photon-based radiation techniques, such as intensity modulated radiation therapy (IMRT), there is a growing awareness of the potential clinical bene fi ts of proton therapy over IMRT in the de fi nitive, postoperative and reirradiation settings given the unique physical properties of protons. Aim of the work : To assess toxicity pro fi le of IMRT in comparison to 3D conformal radiotherapy (3DCRT) and to assess predictors for progression free survival and overall survival rates. Patients and methods : This retrospective cohort study included 131 head and neck cancer patients who were recruited from El Hussein University Hospital over 10 years then they were divided into 2 groups according to the type of radiotherapy. Results : Both groups were comparable regarding age, sex, and associated medical disorders except for ischemic heart disease and smoking. Sites of primary tumors were comparable except tongue and nasopharynx. Most of 3DCRT group received TPF as induction chemotherapy and most of IMRT group received concurrent chemotherapy. Dose of irradiation was higher signi fi cantly among IMRT group. Grades of early and late toxicity were higher among 3DCRT group. There was no statistically signi fi cant difference between both groups regarding response to treatment. Mortality cases were higher signi fi cantly among 3DCRT group. Cox regression analysis was performed to assess predictors for progression free survival and overall survival in each group. Conclusion : IMRT provide good choice as radiotherapy technique for head and neck cancers with adequate ef fi cacy similar to other techniques and better toxicity pro fi le.