Xerostomia and Clinical Outcomes in Definitive Intensity Modulated Radiotherapy (IMRT) Versus Three-dimensional Conformal Radiotherapy (3D-CRT) for Head and Neck Squamous Cell Carcinoma: A Meta-analysis.
In Vivo
; 34(2): 623-629, 2020.
Article
en En
| MEDLINE
| ID: mdl-32111762
ABSTRACT
BACKGROUND/AIM:
Intensity modulated radiotherapy (IMRT) has been compared with three-dimensional conformal radiotherapy (3D-CRT) in randomized clinical trials for head and neck squamous cell carcinoma (HNSCC). The aim of this meta-analysis was to evaluate the efficacy and toxicity of IMRT and 3D-CRT and identify differences in grade ≥2 xerostomia incidence and clinical outcomes. MATERIALS ANDMETHODS:
The preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement was applied. Random-effects models were used. Primary endpoint was xerostomia of grade 2 or worse. Secondary endpoints were overall survival (OS) and loco-regional control (LRC).RESULTS:
Three randomized clinical trials representing 213 patients were identified. Global, grade ≥2 acute xerostomia and late xerostomia at 1 and 2 years after treatment were reduced with the IMRT technique (RR=0.71, 95%CI=0.59-0.86, RR=0.45, 95%CI=0.31-0.65 and RR=0.26, 95%CI=0.15-0.46, respectively). IMRT was not associated with significant OS and LRC improvement compared with 3D-CRT, with OR of 0.70 (95%CI=0.39-1.24; p=0.22) and 1.50 (95%CI=0.75-2.98; p=0.25).CONCLUSION:
This meta-analysis explored the value of IMRT compared to 3D-CRT and confirmed the superiority of IMRT over 3D-CRT in terms of grade ≥2 xerostomia rates, but not on clinical outcomes. Its positive impact on tumor control and survival remains to be proven.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
6_ODS3_enfermedades_notrasmisibles
Problema de salud:
6_larynx_cancer
Asunto principal:
Xerostomía
/
Radioterapia Conformacional
/
Radioterapia de Intensidad Modulada
/
Carcinoma de Células Escamosas de Cabeza y Cuello
Tipo de estudio:
Clinical_trials
/
Diagnostic_studies
/
Etiology_studies
/
Prognostic_studies
/
Systematic_reviews
Límite:
Female
/
Humans
/
Male
Idioma:
En
Revista:
In Vivo
Asunto de la revista:
NEOPLASIAS
Año:
2020
Tipo del documento:
Article
País de afiliación:
Italia