The Outcomes of Intensity Modulated Radiotherapy versus Conventional 2D Radiotherapy in Patients with Oropharyngeal or Hypopharyngeal Squamous Cell Carcinoma. A Case-Control Study
Bibliographic record
Abstract
"Introduction: Head and neck cancers’ radiotherapy (RT) is challenging due to the irregular target volumes and the proximity of multiple organs at risk. The purpose of this study is to compare the toxicity, loco-regional control and the pattern of tumour recurrence after intensity modulated radiotherapy (IMRT) or conventional 2D radiotherapy (2D CRT) in patients with squamous cell carcinoma (SCC) oropharyngeal or hypopharyngeal cancers. Material and method: We retrospectively compared the outcomes of SCC oropharyngeal or hypopharyngeal cases treated by IMRT or 2D CRT from 1998 to 2010 in a Canadian Academic Hospital. We matched the patients in the two groups according to primary tumour location and clinical stage. The information on treatment, toxicity and outcomes was retrieved from patients’ medical records. For the patients having a recurrence after IMRT, the CT scan at relapse was fused with the planning CT. For the patients recurring after 2D CRT, we matched the CT images with the relative position of the radiotherapy fields. Statistical analysis was made using GraphPad Prism software. Results: We included a total of 50 patients in the IMRT group and 50 in the 2D CRT group. The median age was 62 and 58 years, respectively, and the median follow-up was 18 and 22.6 months, respectively. Some of the side effects were less frequent on the IMRT group compared to the 2D CRT: xerostomia (16% vs 64%, P=0.0036), mucositis (70% vs 74% P=0.5451), weight loss (18% vs 46% P= 0.0027), radionecrosis/mandibular fracture (0 % vs 2%), fibrosis (0% vs 10%), and telangiectasia (0% vs 4%). However, acute dermatitis and late dysphagia were more frequent in the IMRT group (44% vs 28% P=0.0042; and 14% vs 2% P=0.028; respectively). The overall survival at 2 years was for 74.03% for IMRT and 60% for 2D CRT (P< 0.001) and the 5 years actuarial locoregional control was 89.54 % for IMRT group, and 62.48% for the 2DCRT group (P< 0.001). Three patients from the IMRT group had a local recurrence (2 in-field and 1 marginal), while in the 2D-CRT group, there were 10 patients with a local recurrence (6 in-field and 4 marginal). Conclusion: SCC oropharyngeal and hypopharyngeal patients treated with IMRT and concurrent cisplatin had better outcomes and fewer side effects, when compared to similar cases treated with 2D CRT. The local recurrence had a similar pattern for both techniques."
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".