Author(s) :

Ahmed, Khalil, Tarek, George.

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Abstract :

Introduction; The purpose of this study is to compare the outcome & the pattern of tumour recurrence after treatment with IMRT&conventional 2D radiotherapy (2DRT) in patients with oropharyngeal& hypopharyngeal cancer. Methods; This is a matched case – control study. The cases are patients treated using IMRT while the control contains patients treated using (2DRT).Review of the medical records with emphasis on the toxicity profile, locoregional control& the pattern of tumour recurrence after radiotherapy as well as fusion of the new CT with the original CT scan on recurrence after IMRT was done. In 2DRT localization of the recurrence either in the high dose or low dose fields or both was made by using the CT data describing the recurrence and matching its site relative to the radiotherapy fields. Results; This study,included 100 patients. Early& late side effects (cases vs control ) were: x[[/+xerostomia 16% vs 64%. Mucositis 70% vs 74%. Dermatitis 44% vs 28% . Desquamation 2%vs 12%. Weight loss 18% vs 46% . Dysphagia 14% in vs 2% . Radionecrosis & mandibular fracture 0 % vs 2% . Fibrosis 0% vs 10%.Telangiectasia 0% vs 4%. The 5 years actuarial locoregional control was 89.54 % in cases vs 62.48% in the control.The recurrent tumours were 66.7 % in field and 33.3% borderline in cases while, in the control group,they were 60% in field, 40% borderline . Conclusion. IMRT improved the therapeutic ratio except for dermatitis& dysphagia. It also added to the locoregional control meanwhile, the recurrent tumours after which almost have the same pattern of recurrence as those seen after conventional 2D radiotherapy.

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