Table 1.
Published studies with either IMRT or conventional techniques. Data included primary site, stage, intention of RT, concomitant chemotherapy or not, followup, and treatment outcome.
| Study | No. of patients |
Primary tumor site |
TN stage | RT | Intention for RT |
Concurrent chemotherapy |
Median followup (Range) |
Treatment outcome % | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Regional control (RC) |
Local control (LC) |
Locoregional control (LRC) |
Distant metastases-free survival (DMFS) |
Disease-free survival (DFS) |
Overall survival (OS) |
||||||||
| no. of pts (%) |
no. of pts (%) |
||||||||||||
| Studer et al. [24] | 29 | Hypopharynx |
T1–T4 N0–N3 |
IMRT |
Def: 90% Post: 10% |
YES (86%) | 16 mths (4–44 mths) | 93% (2yrs) | 90% (2yrs) | — | 93% (2yrs) | 90% (2yrs) | — |
|
| |||||||||||||
| Lee et al. [8] | 41 | Oropharynx | T1–T4 N0–N3 St: III–IVB |
IMRT | Def | Yes | 31 mths (20–64 mths) | 94% (3yrs) | 95% (3yrs) | 92% (3yrs) | 86% (3yrs) | 82% (3yrs) | 91% (3yrs) |
| 71 | Oropharynx | T1–T4 N0–N3 St: III–IVB |
2DRT | Def | Yes | 46 mths (3–93 mths) | 95% (3yrs) | 85% (3yrs) | 82% (3yrs) | 85% (3yrs) | 76% (3yrs) | 81% (3yrs) | |
|
| |||||||||||||
| Garden et al. [25] | 51 | Oropharynx | Tx, T1-T2 Nx, N0–N3 |
IMRT | Def | Yes (8%) | 45 mths (15–63 mths) | — | 96% (2yrs) | 93% (2yrs) | — | 87% (2yrs) | 93% (2yrs) |
|
| |||||||||||||
| Daly et al. [26] | 107 | Oropharynx | T1–T4 N0–N3 St: II–IV |
IMRT | Def: 80% Post: 20% |
Yes (87%) | 29 mths (4–105 mths) | — | — | 92% (3yrs) | 92% (3yrs) | 81% (3yrs) | 83% (3yrs) |
|
| |||||||||||||
| Chao et al. [27] | 74 | Oropharynx | T1–T4 N0–N3 St: I–IV |
IMRT | Def: 42% Post: 58% |
Yes (23%) | 33 mths (9–60 mths) | — | — | 87% (3yrs) | 90% (4yrs) | 81% (4yrs) | 87% (4yrs) |
|
| |||||||||||||
| Huang et al. [28] | 71 | Oropharynx | T1–T4 N0–N3 St: III-IV |
IMRT | Def | Yes | 33 mths (3–72 mths) | 94% (3yrs) | 94% (3yrs) | 90% (3yrs) | — | — | 83% (3yrs) |
|
| |||||||||||||
| Setton et al. [29] | 442 | Oropharynx | T1–T4 N0–N3 St: I–IV |
IMRT | Def: 93% Post: 7% |
Yes (88%) | 36.8 mths (3–135 mths) | 94.4% (3yrs) | 94.6% (3yrs) | — | 87.5% (3yrs) | — | 84.9% (3yrs) |
|
| |||||||||||||
| Schoenfeld et al. [30] | 64 | Oropharynx | T1–T4 N0–N3 St: I–IVB |
IMRT | Def | Yes (54%) | 36 mths (12–62 mths) | 94% (3yrs) | 90% (3yrs) | — | RFS: 86% (3yrs) |
84% (3yrs) | |
|
| |||||||||||||
| Clavel et al. [9] | 100 | Oropharynx | T1–T4 N0–N3 St: III–IVB |
IMRT | Def | Yes | 42 mths | 95.1% (3yrs) | 85.3% (3yrs) | 92.1% (3yrs) | |||
| 149 | Oropharynx | T1–T4 N0–N3 St: III–IVB |
2-3DRT | Def | YES | 42 mths | 84.4% (3yrs) | 69.3% (3yrs) | 75.2% (3yrs) | ||||
|
| |||||||||||||
| Sanguineti et al. [31] | 50 | Oropharynx | Tx, T1–T4 N0–N3 |
IMRT | Def | No | 32.6 mths (12.1–58.6 mths) |
85% (3yrs) | 94% (3yrs) | ||||
|
| |||||||||||||
| De Arruda et al. [32] | 50 | Oropharynx | T1–T4 N0–N3 St: I–IV |
IMRT | Def: 96% Post: 4% |
Yes (86%) | 18 mths (8.4–76 mths) | 88% (2yrs) | 98% (2yrs) | 84% (2yrs) | 98% (2yrs) | ||
|
| |||||||||||||
| Fang et al. [10] | 113 | Nasopharynx | T1–T4 N0–N3 St: I–IV |
IMRT | Def | Yes (57.3%) | 40 mths (5–57 mths) | — | — | 84% (3yrs) | 83% (3yrs) | — | 85% (3yrs) |
| 93 | Nasopharynx | T1–T4 N0–N3 St: I–IV |
3D-CRT | Def | Yes (54.8%) | 46 mths (10–59 mths) | — | — | 84.8% (3yrs) | 76.7% (3yrs) | — | 81.7% (3yrs) | |
|
| |||||||||||||
| Wong et al. [33] | 175 | Nasopharynx | T1–T4 N0–N3 St: I–IVB |
IMRT | Def | Yes (70%) | 34 mths (9–50 mths) | 93.3% (3yrs) | 93.6% (3yrs) | 86.6% (3yrs) | 87.2% (3yrs) | ||
|
| |||||||||||||
| Kwong et al. [34] | 33 | Nasopharynx |
T1–T3 N0-N1 |
IMRT | Def | No | 24 mths (11–42 mths) | 93% (3yrs) | 100% (3yrs) | — | 100% (3yrs) | — | 100% (3yrs) |
|
| |||||||||||||
| Wolden et al. [35] | 74 | Nasopharynx | T1–T4 N0–N3 St: I–IVB |
IMRT | Def | Yes (93%) | 35 mths (3–74 mths) | 93% (3yrs) |
91% (3yrs) |
— | 78% (3yrs) | 67% (3yrs) | 83% (3yrs) |
|
| |||||||||||||
| Kam et al. [36] | 63 | Nasopharynx | T1–T4 N0–N3 St: I–IV |
IMRT | Def | Yes (30%) | 29 mths (8–45 mths) | 98% (3yrs) | 92% (3yrs) | — | 79% (3yrs) | — | 90% (3yrs) |
|
| |||||||||||||
| Tham et al. [37] | 107 | Nasopharynx | T1–T2 N0–N1 St: IIB |
IMRT | Def | Yes (7%) | 39 mths (7–77 mths) | 98% (3yrs) | 96.5% (3yrs) | 94.8% (3yrs) | 90.7% (3yrs) | 95.8% (3yrs) | |
|
| |||||||||||||
| Lee et al. [38] | 68 | Nasopharynx | T1–T4 N0–N3 St: I–IVB |
IMRT | Def | Yes (65%) | 31 mths (6–55 mths) | 90.8% (2yrs) | 92.6% (2yrs) | 89.3% (2yrs) | 84.7% (2yrs) | 72.7% (2yrs) | 80.2% (2yrs) |
|
| |||||||||||||
| Tham et al. [39] | 195 | Nasopharynx | T1–T4 N0–N3 St: I–IVB |
IMRT | Def | Yes (57%) | 36.5 mths | 89.6% (3yrs) | 89.2% (3yrs) | 79% (3yrs) | 94.3% (3yrs) | ||
|
| |||||||||||||
| Lee et al. [40] | 67 | Nasopharynx | T1–T4 N0–N3 St: I–IV |
IMRT | Def | Yes (75%) | 31 mths (7–72 mths) | 98% (4yrs) | 97% (4yrs) | — | 66% (4yrs) | — | 88% (4yrs) |
|
| |||||||||||||
| Liu et al. [41] | 19 | Nasopharynx | T1–T4 N0–N3 St: I–IV |
IMRT | Def | Yes (58%) | 13.0 mths (8–18 mths) | — | — | 100% (13 mths) |
|||
|
| |||||||||||||
| Luo et al. [42] | 58 | Nasopharynx | T1–T4 N0–N3 St: I-II |
3D-CRT | Def | No | 58 mths (25–92 mths) | — | — | 93% (5yrs) | 98% (5yrs) | 91% (5yrs) | 95% (5yrs) |
|
| |||||||||||||
| Wang et al. [43] | 300 | Nasopharynx | T1–T4 N0–N3 St: IIB |
IMRT | Def | Yes (83%) | 47.1 mths (11–68 mths) | 95.1% (4yrs) | 94% (4yrs) | — | 85% (4yrs) | — | 86.1% (4yrs) |
|
| |||||||||||||
| Sultanem et al. [44] | 35 | Nasopharynx | T1–T4 N0–N3 St: I–IVB |
IMRT | Def | Yes (91%) | 21.8 mths (5–49 mths) | 100% (4yrs) | 57% (4yrs) | 57% (4yrs) | 94% (4yrs) | ||
|
| |||||||||||||
| Su et al. [45] | 198 | Nasopharynx | T1-T2 N0-N1 St: I–IIB |
IMRT | Def | No | 50.9 mths (12–104 mths) | 97.7% (5yrs) | 97.8% (5yrs) | 97.3% (5yrs) | |||
|
| |||||||||||||
| Kim et al. [46] | 21 | Nasopharynx | T2–T4 N0–N2 St: III-IV |
3D-CRT | Def | No | 48 mths | 85% (5yrs) | 61% (5yrs) | ||||
|
| |||||||||||||
| Al-Mamgani et al. [47] | 170 | Larynx | T3 N0–N3 |
IMRT + 3D-CRT |
Def | Yes (28.3%) | 32 mths (7–172 mths) | — | 73% (3yrs) | 70% (3yrs) | 64% (3yrs) | 61% (3yrs) | |
|
| |||||||||||||
| Studer et al. [48] | 58 | Oral cavity |
Def T2–T4 N0–N3 St: IVA-B Post T1–T4 N0–N2c St: II–IVA |
IMRT | Def: 52% Post: 48% |
Yes (78%) | Def: 19 mths Post: 12 mths |
Def: 43% (2yrs) Post: 92% (2yrs) |
— | — | Def: 40% (2yrs) Post: 87% (2yrs) |
Def: 30% (2yrs) Post: 83% (2yrs) |
|
|
| |||||||||||||
| Chen et al. [21] | 22 | Oral cavity |
T1–T4 N0–N2c St: III-IV |
IMRT | Post | Yes (9%) | 44 mths | 64% (3yrs) | 67% (3yrs) | ||||
| 27 | Oral cavity | T1–T4 N0–N2c St: III-IV |
3D-CRT | Post | Yes (2%) | 44 mths | 66% (3yrs) | 77% (3yrs) | |||||
|
| |||||||||||||
| Yao et al. [49] | 55 | Oral cavity | Tx–T4 N0–N2c St: I–IV |
IMRT | Def: 9% Post: 91% |
Yes Def: 6% Post: 4% |
23.9 mths (9.3–59.3 mths) | 85% (3yrs) | 82% (3yrs) | 89% (3yrs) | 74% (3yrs)* | 68% (3yrs) | |
|
| |||||||||||||
| Lee et al. [50] | 31 | Various | T1–T4 N0–N2 St: I–IVB |
IMRT | Def | Yes (65%) | 26 mths (17–58 mths) | 86% (2yrs) | 94% (2yrs) | 92% (2yrs) | 63% (2yrs) | ||
|
| |||||||||||||
| Van Gestel et al. [51] | 78 | Various | Tx, T1–T4 Nx, N0–N3 St: I–IVB |
IMRT | Def: 62% Post: 38% |
Yes Def: 63% Post: 23% |
18.7 mths (0.13–51.7 mths) | Def: 66.8% (3yrs) Post: 82.2% (3yrs) |
Def: 42.6% (3yrs) Post: 82.2% (3yrs) |
Def: 60.3% (3yrs) Post: 85.9% (3yrs) |
|||
|
| |||||||||||||
| Peponi et al. [52] | 82 | Various | St: I–IV | IMRT | Def: 77% Post: 23% |
Yes (85%) | 55 mths | 78% (3yrs) | 80% (3yrs) | ||||
|
| |||||||||||||
| Gupta et al. [23] | 28 | Various | T1–T3 N0–N2b St: I–IV |
3D-CRT | Def | Yes | 40 mths (26–50 mths) | 88.2% (3yrs) | 70.6% (3yrs) | ||||
| 32 | Various | T1–T3 N0–N2b St: I–IV |
IMRT | Def | Yes (90%) | 40 mths (26–50 mths) | 88.2% (3yrs) | 68% (3yrs) | |||||
|
| |||||||||||||
| Lambrecht et al. [18] | 135 | Various | T1–T4 N0–N3 St: III-IV |
3D-CRT | Def | Yes (80%) | 68 mths (37.2–104 mths) | 71% (3yrs) | 61% (3yrs) | ||||
| 110 | Various | T1–T4 N0–N3 St: III-IV |
IMRT | Def | Yes (81%) | 35 mths (4.7–63.5 mths) | 70% (3yrs) | 64% (3yrs) | |||||
|
| |||||||||||||
| Toledano et al. [53] | 208 | Various | St: I–IV | IMRT | Def: 55% Post: 45% |
Yes (37.5%) | 25.3 mths (0.4–72 mths) | — | — | 86% (2yrs) | 92.7% (2yrs) | 80% (2yrs) | 86.7% (2yrs) |
|
| |||||||||||||
| Rades et al. [22] | 104 | Various | T0–T4 N0–N3 St: I–IV |
2DRT | Post | Yes (8%) | 78% (2yrs) | 79% (2yrs) | 74% (2yrs) | ||||
| 26 | Various | T0–T4 N0–N3 St: I–IV |
3D-CRT | Post | Yes (23%) | 79% (2yrs) | 83% (2yrs) | 80% (2yrs) | |||||
| 18 | Various | T0–T4 N0–N3 St: I–IV |
IMRT | Post | Yes (6%) | 89% (2yrs) | 80% (2yrs) | 86% (2yrs) | |||||
|
| |||||||||||||
| Yao et al. [54] | 150 | Various | T0–T4 N0–N3 St: I–IV |
IMRT | Def: 66% Post: 34% |
Yes (45%) | 18 mths (2–60 mths) | 94% (2yrs) | 92% (2yrs) | 87% (2yrs) | 85% (2yrs) | ||