COMPARISON OF TOXICITY PROFILES AMONG HEAD & NECK CANCER PATIENTS UNDERGOING 3D CRT, IMRT & IGRT MODES OF RADIOTHERAPY

Abstract

Introduction: Radiotherapy is the one of the main modes of treating oral cancer and in recent days radiation delivery and beam shaping is evolving with novel methods. Some of the methods of radiation delivery include Three dimensional conformal radiotherapy(3D CRT), Intensity Modulated Radiotherapy ( IMRT), Image Guided Radiotherapy ( IGRT), stereotactic body radiotherapy and proton beam therapy to name a few. However these techniques are always associated with some pitfalls such as mucositis, skin reactions, dysphagia and xerostomia which occur in both acute and chronic manner. Hence there is a continuous necessity to optimize dose distribution to reduce the toxicities and have a positive impact on the quality of life of the patient. Aim: To assess and compare the toxicity proles occurring due to radiotherapy in head and neck cancer patients undergoing 3D CRT, IMRT and IGRTmodes. Materials and Methods: A total of 60 patients with a Kornofsky Performance Scale (KPS) more than 70 were included in the study. Of the 60 patients included in the study 20 were in the 3D CRT group, 20 were in the IMRT group and 20 were in the IGRT group. The patients were assessed for grade of mucositis and skin reactions in an acute and chronic manner. Results: The results showed that 3D CRT group demonstrated signicantly more acute and chronic toxicities in relation to mucositis and skin reactions when compared to IMRT and IGRT. However on comparing the toxicities between IMRT and IGRT groups there were insignicant differences. Conclusion: In our study, IMRT and IGRT were associated with a signicantly lower incidence of toxicity in relation to mucositis and skin reactions and hence they are more tissue sparing and improves the quality of life of the patient.