Produção Nacional
Revisado por pares
Intensity-modulated radiation therapy for head and neck cancer: Systematic review and meta-analysis
2013; Elsevier BV; Volume: 110; Issue: 1 Linguagem: Inglês
10.1016/j.radonc.2013.11.010
ISSN1879-0887
AutoresGustavo Nader Marta, Valter Silva, Heloísa de Andrade Carvalho, Fernando Freire de Arruda, Samir Abdallah Hanna, Rafael Gadia, João Luís Fernandes da Silva, Sebastião Francisco Miranda Corrêa, Carlos Eduardo Cintra Vita Abreu, Rachel Riera,
Tópico(s)Colorectal and Anal Carcinomas
ResumoBackground and purpose Intensity-modulated radiation therapy (IMRT) provides the possibility of dose-escalation with better normal tissue sparing. This study was performed to assess whether IMRT can improve clinical outcomes when compared with two-dimensional (2D-RT) or three-dimensional conformal radiation therapy (3D-CRT) in patients with head and neck cancer. Methods and materials Only prospective phase III randomized trials comparing IMRT with 2D-RT or 3D-CRT were eligible. Combined surgery and/or chemotherapy were allowed. Two authors independently selected and assessed the studies regarding eligibility criteria and risk of bias. Results Five studies were selected. A total of 871 patients were randomly assigned for 2D-RT or 3D-CRT (437), versus IMRT (434). Most patients presented with nasopharyngeal cancers (82%), and stages III/IV (62.1%). Three studies were classified as having unclear risk and two as high risk of bias. A significant overall benefit in favor of IMRT was found (hazard ratio – HR = 0.76; 95% CI: 0.66, 0.87; p < 0.0001) regarding xerostomia scores grade 2–4, with similar loco-regional control and overall survival. Conclusions IMRT reduces the incidence of grade 2–4 xerostomia in patients with head and neck cancers without compromising loco-regional control and overall survival.
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