Acta Med. 2006, 49: 167-173

IMRT with the Use of Simultaneous Integrated Boost in Treatment of Head and Neck Cancer: Acute Toxicity Evaluation

Milan Vošmika, Karel Odrážkaa, Martin Doležela, Miloslava Vaculíkováa, Petr Kordačb, Milan Zouhara, Jiří Peteraa, Jan Jansaa, Zdeněk Zoula, Petr Paluskaa, Jan Vokurkab

aCharles University in Prague, Faculty of Medicine and University Hospital in Hradec Králové, Department of Oncology and Radiotherapy, Hradec Králové, Czech Republic
bCharles University in Prague, Faculty of Medicine and University Hospital in Hradec Králové, Department of Otolaryngology, Head and Neck Surgery, Hradec Králové, Czech Republic

Received August 1, 2006
Accepted September 1, 2006

Acute toxicity has been evaluated in head and neck cancer patients treated with intensity-modulated radiotherapy using simultaneous integrated boost (SIB-IMRT). The basis of the treatment protocol is an irradiation in 30 fractions with a total dose: 66 Gy to the region of macroscopic tumor, 60 Gy to the region of high-risk subclinical disease and 54 Gy to the region of low-risk subclinical disease. Between December 2003 and September 2005, 38 patients with carcinoma of different locations in the head and neck region were irradiated. Five patients underwent concurrent chemotherapy (weekly cisplatin). Acute toxicity was evaluated according to Radiation Therapy Oncology Group toxicity scale for skin, mucous membrane, salivary glands, pharynx and esophagus and larynx. All 38 patients completed the therapy without urgency of interruption due to acute toxicity of radiotherapy. No patient experienced grade 4 toxicity. More severe toxicity was observed in patients with concurrent chemotherapy. The results confirm that the irradiation according to our SIB-IMRT protocol is a therapy with acceptable toxicity and there is a space for radiobiological enhancement of this regimen by concurrent chemotherapy, e.g. weekly cisplatin.


The study is supported in part by Charles University Grant Agency, Czech Republic (137/2004 C) and by Internal Grant Agency of the Ministry of Health, Czech Republic (NR 8061–3/2004).


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