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BioMed Research International
Volume 2013, Article ID 401261, 12 pages
Review Article

The Treatment Outcome and Radiation-Induced Toxicity for Patients with Head and Neck Carcinoma in the IMRT Era: A Systematic Review with Dosimetric and Clinical Parameters

1Second Department of Radiology, Radiotherapy Unit, Attikon University Hospital, Medical School, Rimini 1, Xaidari, 12462 Athens, Greece
2First Department of Radiology, Radiotherapy Unit, Aretaieion University Hospital, Medical School, Vas. Sofias 76, 11528 Athens, Greece

Received 16 May 2013; Revised 8 August 2013; Accepted 22 August 2013

Academic Editor: Tsair-Fwu Lee

Copyright © 2013 Vassilis Kouloulias et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


A descriptive analysis was made in terms of the related radiation induced acute and late mucositis and xerostomia along with survival and tumor control rates (significance level at 0.016, bonferroni correction), for irradiation in head and neck carcinomas with either 2D Radiation Therapy (2DRT) and 3D conformal (3DCRT) or Intensity Modulated Radiation Therapy (IMRT). The mean score of grade II xerostomia for IMRT versus 2-3D RT was 0.31 ± 0.23 and 0.56 ± 0.23, respectively (Mann Whitney, ). The parotid-dose for IMRT versus 2-3D RT was 29.56 ± 5.45 and 50.73 ± 6.79, respectively (Mann Whitney, ). The reported mean parotid-gland doses were significantly correlated with late xerostomia (spearman test, rho = 0.5013, ). A trend was noted for the superiority of IMRT concerning the acute oral mucositis. The 3-year overall survival for either IMRT or 2-3DRT was 89.5% and 82.7%, respectively ( , Kruskal-Wallis test). The mean 3-year locoregional control rate was 83.6% (range: 70–97%) and 74.4 (range: 61–82%), respectively ( , Kruskal-Wallis). In conclusion, no significant differences in terms of locoregional control, overall survival and acute mucositis could be noted, while late xerostomia is definitely higher in 2-3D RT versus IMRT. Patients with head and neck carcinoma should be referred preferably to IMRT techniques.