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How much radiation is the chemotherapy worth in advanced head and neck cancer?

Publication ,  Journal Article
Kasibhatla, M; Kirkpatrick, JP; Brizel, DM
Published in: Int J Radiat Oncol Biol Phys
August 1, 2007

PURPOSE: To estimate the radiotherapeutic dose equivalence of chemoradiotherapy in head and neck cancer. METHODS: The biologic equivalent dose (BED) of radiotherapy in nine trials of standard and five trials of modified fractionated radiotherapy with or without chemotherapy was calculated using the linear-quadratic formulation. Data from Radiation Therapy Oncology Group (RTOG) study 90-03 were used to calculate the relationship (S) between increase in locoregional control (LRC) and increase in BED with modified vs. standard fractionated radiotherapy. The increase in LRC with chemoradiotherapy vs. radiotherapy alone, the BED of the radiotherapy-alone arms, and the "S" value were used to calculate the BED contribution from chemotherapy and the total BED of chemoradiotherapy from each study. RESULTS: From RTOG 90-03, a 1% increase in BED yields a 1.1% increase in LRC. The mean BED of standard fractioned radiotherapy was 60.2 Gy(10) and 66 Gy(10) for modified fractionation. The mean BED of standard fractionated chemoradiotherapy was 71 Gy(10) (10.8 Gy(10) contributed by chemotherapy). The mean BED of modified fractionated chemoradiotherapy was 76 Gy(10) (10.4 Gy(10) contributed by chemotherapy). CONCLUSIONS: Chemotherapy increases BED by approximately 10 Gy(10) in standard and modified fractionated radiotherapy, equivalent to a dose escalation of 12 Gy in 2 Gy daily or 1.2 Gy twice daily. Such an escalation could not be safely achieved by increasing radiation dose alone.

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Published In

Int J Radiat Oncol Biol Phys

DOI

ISSN

0360-3016

Publication Date

August 1, 2007

Volume

68

Issue

5

Start / End Page

1491 / 1495

Location

United States

Related Subject Headings

  • Therapeutic Equivalency
  • Relative Biological Effectiveness
  • Randomized Controlled Trials as Topic
  • Radiotherapy Dosage
  • Oncology & Carcinogenesis
  • Humans
  • Head and Neck Neoplasms
  • Combined Modality Therapy
  • Clinical Trials as Topic
  • Antineoplastic Agents
 

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Kasibhatla, M., Kirkpatrick, J. P., & Brizel, D. M. (2007). How much radiation is the chemotherapy worth in advanced head and neck cancer? Int J Radiat Oncol Biol Phys, 68(5), 1491–1495. https://doi.org/10.1016/j.ijrobp.2007.03.025
Kasibhatla, Mohit, John P. Kirkpatrick, and David M. Brizel. “How much radiation is the chemotherapy worth in advanced head and neck cancer?Int J Radiat Oncol Biol Phys 68, no. 5 (August 1, 2007): 1491–95. https://doi.org/10.1016/j.ijrobp.2007.03.025.
Kasibhatla M, Kirkpatrick JP, Brizel DM. How much radiation is the chemotherapy worth in advanced head and neck cancer? Int J Radiat Oncol Biol Phys. 2007 Aug 1;68(5):1491–5.
Kasibhatla, Mohit, et al. “How much radiation is the chemotherapy worth in advanced head and neck cancer?Int J Radiat Oncol Biol Phys, vol. 68, no. 5, Aug. 2007, pp. 1491–95. Pubmed, doi:10.1016/j.ijrobp.2007.03.025.
Kasibhatla M, Kirkpatrick JP, Brizel DM. How much radiation is the chemotherapy worth in advanced head and neck cancer? Int J Radiat Oncol Biol Phys. 2007 Aug 1;68(5):1491–1495.
Journal cover image

Published In

Int J Radiat Oncol Biol Phys

DOI

ISSN

0360-3016

Publication Date

August 1, 2007

Volume

68

Issue

5

Start / End Page

1491 / 1495

Location

United States

Related Subject Headings

  • Therapeutic Equivalency
  • Relative Biological Effectiveness
  • Randomized Controlled Trials as Topic
  • Radiotherapy Dosage
  • Oncology & Carcinogenesis
  • Humans
  • Head and Neck Neoplasms
  • Combined Modality Therapy
  • Clinical Trials as Topic
  • Antineoplastic Agents