Study: IMRT boosts quality of life for head and neck cancer patients

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Patients with head and neck cancers who have been treated with intensity-modulated radiation therapy (IMRT) enjoy a better quality of life than those treated with 3D conformal radiation therapy, according to a study presented Jan. 27 at the Multidisciplinary Head and Neck Cancer Symposium in Phoenix.

The study conducted by researchers from University of California, Davis (UC Davis) is the first of its kind to measure long-term quality of life among cancer patients who have undergone radiation therapy for advanced head and neck cancers.

Allen M. Chen, MD, assistant professor and director of the residency and fellowship training program in UC Davis' department of radiation oncology, reported that the use of IMRT was associated with fewer long-term side effects, which led to a better quality of life. Standard radiation therapy to the head and neck has been known to affect a patient's ability to produce saliva, taste and chew food. These side effects historically have resulted in permanent disabilities.

Chen and colleagues used the University of Washington Quality of Life instrument, a standardized, previously validated questionnaire that patients complete after radiation therapy. The researchers prospectively administered the survey to 155 patients at UC Davis Cancer Center diagnosed with head and neck cancers, 54 percent of whom were initially treated with IMRT and 46 percent of whom were treated with 3D conformal radiation therapy.

All of the patients receiving IMRT also underwent image-guided radiotherapy (IGRT), which images the tumor daily during treatment to fine-tune dose delivery.

Chen and his colleagues found early gains observed in quality of life, which magnified over time, for those who received IMRT treatment.

According to the study abstract, one year after treatment, 51 percent of the IMRT patients rated their quality of life as very good or outstanding, compared to 41 percent of non-IMRT patients. Two years after treatment, the percentages changed to 73 percent and 49 percent, respectively.

The researchers completed a multivariate analysis accounting for gender age, definitive vs. postoperative radiation intent, radiation dose, T-stage, primary site, use of concurrent chemotherapy and neck dissection. IMRT was the only variable independently associated with improved quality of life, Chen et al reported in the abstract.

The researchers acknowledged that quality of life is difficult to measure because of its subjective nature. However, Chen said the findings support the more widespread use of IMRT in radiation clinics throughout the country.

"There has been some reluctance to utilize it because it is expensive, resource intensive and takes on average 10 to 12 hours to prepare a single patient's treatment," he said in a statement. "I think this is further evidence that our investment in developing newer technologies is really paying off."