HNSCC: IMRT tied to less xerostomia vs 2D/3D RT in India meta-analysis

  • Gupta T & al.
  • PLoS One
  • 1 Jan 2018

  • curated by Brian Richardson, PhD
  • Univadis Clinical Summaries
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Takeaway

  • A systematic review suggests that intensity-modulated radiation therapy (IMRT) reduces the risk for xerostomia compared with 2D/3D radiotherapy (RT) in patients with head and neck squamous cell carcinoma (HNSCC).

Why this matters

  • Meta-analysis attempts to correct for small sample size and statistical power of individual studies.

Key results

  • IMRT was associated with reduced risk for grade ≥2 acute xerostomia (relative risk [RR], 0.64; P=.001) and grade ≥2 late xerostomia (RR, 0.44; P=.00001) compared with 2D-/3D-RT.
  • IMRT was nonsignificantly associated with reduced risk for locoregional relapse compared with 2D-/3D-RT (HR, 0.76; P=.06), with low sample size and statistical power.
    • IMRT was associated with significantly reduced risk in patients with nasopharyngeal cancer (HR, 0.52; P=.003) but not in patients with laryngopharynx cancer (HR, 1.06; P=.78).
  • IMRT was associated with reduced mortality risk compared with 2D-/3D-RT (HR, 0.70; P=.002), with low sample size and statistical power.
    • IMRT was associated with significantly reduced risk in patients with nasopharyngeal cancer (HR, 0.57; P=.0005) but not in patients with laryngopharynx cancer (HR, 0.85; P=.29).

Study design

  • 7 randomized controlled trials (RCTs) with 1155 patients with HNSCC were subjected to meta-analysis to compare IMRT and 2D-/3D-RT.
  • Funding: None.

Limitations

  • High risk for bias for disease-related outcomes.

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