Advanced Radiotherapy Improved Head & Neck Cancer Survival

Head and neck cancer responded well to IMRT

(RxWiki News) Traditional radiation treatments for head and neck cancers can cause some unpleasant side effects, including dry mouth and problems swallowing. Radiologists are looking for ways to reduce these side effects but maintain cancer fighting effectiveness.

A new study revealed that intensity-modulated radiation therapy (IMRT) outperformed conventional radiotherapy both in terms of fewer side effects and improved survival.

While IMRT demonstrated patient benefits, the technology is more expensive to use. Therefore, the authors of this study urged more research to prove the cost-effectiveness of IMRT.

"If you have difficulty swallowing, visit your doctor."

Beth Beadle, MD, PhD, of the University of Texas MD Anderson Cancer Center in Houston, and her colleagues designed this study to evaluate if IMRT helped head and neck cancer patients live longer.

Head and neck cancer can start anywhere in mouth, nose, sinuses, voice box and throat.

IMRT uses multiple beams of radiation. Radiation oncologists can control these beams to conform to the size and shape of the tumor, using various dosages, while avoiding healthy tissue.

This advanced radiotherapy was approved in 1999 and its use has skyrocketed since then, in large part because IMRT reduces life-altering side effects for head and neck cancer patients. These toxicities include chronic dry mouth, range of motion problems and dental complications, including cavities.

So IMRT has shown itself to be a less toxic treatment for head and neck cancers, but no research has looked at the technique's survival benefits.

Dr. Beadle and team analyzed data on 3,172 individuals treated for head and neck cancer with both IMRT and other forms of radiation between 1999 and 2007. Patient information came from the Surveillance, Epidemiology and End Results (SEER) Medicare database, compiled by the National Cancer Institute.

Altogether, 1,056 patients were treated with IMRT, and 2,116 individuals received conventional therapy.

After 40 months of follow-up, the cause-specific survival (death caused by head and neck cancer) for those treated with IMRT was 38.9 percent, compared to 18.9 percent for those who were treated with conventional radiation techniques.

David Horvick, MD, a Radiation Oncologist with 21st Century Oncology of New Jersey, told dailyRx News, “Although retrospective, this study strongly suggests a significantly improved rate of cancer control in patients who received IMRT as opposed to non-IMRT radiation therapy for head and neck cancer. This information combined with IMRT's proven benefit in terms of decreased side effects, strengthens IMRT role as the standard of care for head and neck cancer,” Dr. Horvick said.

IMRT is more expensive than conventional radiation treatment. A 2013 study found that compared to conventional radiotherapy, IMRT increased total costs by $5,881.

Dr. Beadle said that additional research is needed to study the cost-effectiveness of IMRT, and noted that if the therapy can reduce or eliminate subsequent disease recurrences, or treatment-related side effects, the cost impact could be favorable.

This study was published January 13 in in Cancer, a peer-reviewed journal of the American Cancer Society.

No funding information was provided and no conflicts of interest were disclosed.

Review Date: 
January 13, 2014