Intensity-Modulated Radiotherapy for Oropharyngeal Squamous Cell Carcinoma

Objectives/Hypothesis: To report the outcomes after intensity-modulated radiotherapy (IMRT) for patients with oropharyngeal squamous cell carcinoma. Study Design: Retrospective review. Methods: Between July 2001 and March 2007, a total of 130 patients were treated with definitive IMRT for squamous cell carcinoma of the oropharynx. Forty-seven patients (36%) had T3 (26 patients) or T4 (21 patients) cancers and 117 patients (90%) had overall stage III to IV disease. The fractionation schedules employed included the following: once daily, 12 patients (9%); hyperfractionation, three patients (2%); and concomitant boost, 115 patients (89%). Seventy-nine patients (61%) received adjuvant chemotherapy, and 54 patients (42%) underwent a planned neck dissection. Median follow-up was 3.5 years, (range, 0.2-7.7 years). Median follow-up for surviving patients was 3.8 years (range, 2.1-7.7 years). Results: The 5-year local control rates were as follows: T1, 93%; T2, 91%; T3, 82%; T4, 67%; and overall, 87%. The 5-year local-regional control rates were as follows: stage I to II, 92%; stage III, 72%; stage IVA, 94%; stage IVB, 71%; and overall, 84%. The 5-year distant metastasis-free survival rate was 93%. The 5-year cause-specific and overall survival rates were 85% and 76%, respectively. Severe late complications occurred in 11 patients (8%). Conclusions: In our experience, IMRT resulted in local-regional control rates that are comparable to those achieved with more conventional techniques with a similar risk of severe complications.