Oral complications in irradiated head and neck cancer patients - 3D conformal radiotherapy planning vs. 3D conformal radiotherapy planning with magnetic resonance fusion

摘要

Introduction/Objective. The incidence of radiation-induced side effects in patients with head and neck (H&N) cancer depends on the planning technique and the irradiation dose, as well as primary tumor location within the H&N region. The aim of our research is to establish the incidence of side effects in patients with H&N cancer treated with conformal radiotherapy planning with computed tomography (CT) or computed tomography fusion with magnetic resonance imaging (CT-MRI fusion). Methods. Prospective analysis was performed on 40 patients with oropharynx carcinoma and on 40 patients with larynx carcinoma prospectively followed after radiotherapy. Forty patients with H&N cancer were irradiated by using 3D conformal radiotherapy planning with CT, while other 40 patients were treated using 3D conformal radiotherapy planning with CT-MRI fusion. In all cases standard fractionation was used at 2 Gy per day, five days a week. Results. Of the total of 80 patients treated, 52 patients (52/80; 65%) reported a side effect and the incidence of complications was higher in patients irradiated with 3D technique planning with CT (31/52; 60% for 3D CT vs. 21/52; 40% for 3D CT-MRI; p = 0.02). There were more complications in chemoradiotherapy group of patients than observed when only radiotherapy was used – 35/52 RT + HT vs. 17/52 RT (67%: 33% and p = 0.004). Conclusion. 3D radiotherapy technique planned solely on the basis of CT is related to high incidence of toxicity, which significantly affects the quality of life of irradiated patients. 3D conformal radiotherapy planned with CT-MRI fusion reduces the incidence of oral complications. Following the example of developed countries, this technique should be considered as a standard method for irradiating patients with H&N cancer. Planning technique with fusion technique using MR imaging is more suitable for delivering higher doses to the tumor with fewer side effects.