Implementing Intensity-modulated Radiotherapy with Simultaneous Integrated Boost for XXXX : 3 Year Outcomes at Two Sydney Institutions.

@entity1 @entity137 @entity5 @entity1138 @entity3 @entity1487
AIMS: Modern chemoradiotherapy used for the treatment of @entity5 has significant acute @entity137 . Intensity-modulated radiotherapy (IMRT) may reduce these side-effects. We report our experience implementing IMRT with simultaneous boost at the @entity5 Centre and Royal North Shore Hospital. MATERIALS AND METHODS: We retrospectively collected acute @entity137 data on all consecutive @entity1 treated definitively with IMRT between January 2008 and December 2011. @entity1 received concurrent @entity1487 and @entity1138 . The radiotherapy dose varied by stage in accordance with the Radiation Therapy Oncology Group (RTOG) 0529 protocol. The first 30 plans were evaluated for adherence to RTOG 0529 dose specifications. Locoregional control and survival outcomes were analysed in July 2014. RESULTS: We included 42 @entity1 (stage I 12%; II 41%; III 45%) with a median follow-up time of 43 months. At 3 years the locoregional control was 94% (95% confidence interval: 78-99), overall survival was 92% (95% confidence interval: 78-97), disease-free survival was 89% (95% confidence interval: 73-96), @entity3 -free survival was 89% (95% confidence interval: 73-96) and colostomy-free survival was 89% (95% confidence interval: 72-96). There was no acute grade 4 @entity137 . Acute grade 3 @entity137 rates were: dermatological (33%), gastrointestinal (14%) and haematological (19%). Twenty-six per cent of @entity1 were hospitalised for treatment-related @entity137 . Only 12% required a treatment break greater than 3 days. All @entity1 achieved RTOG 0529 planning target volume dose specifications. Most critical organ dose constraints were either met or met with minor deviation. The exception was 76% major deviation in small bowel constraints. Despite this no increase in gastrointestinal @entity137 was observed. CONCLUSIONS: IMRT with simultaneous integrated boost is safe and well tolerated in an unselected population. Most dose specifications are achievable. Excellent locoregional control and survival outcomes are achievable outside of a clinical trial setting.
