Comparison of Failure Patterns Between Conventional and Intensity-modulated Radiotherapy for Stage III and IV Head and Neck Squamous Cell Carcinoma

Abstract

Background: We compared the patterns of failure between 3-dimensional radiotherapy (3D-RT) and intensity-modulated radiotherapy (IMRT) for head and neck squamous cell carcinoma (HNSCC). Patients and Methods: We reviewed the medical records of 49 patients with stage III-IV HNSCC treated with concurrent chemoradiotherapy. The treatment outcome, patterns of failure, and toxicities were compared between 3D-RT and IMRT. Results: There were 13 locoregional recurrences as initial failure sites. Eight recurrences were local, three were regional, and two were both local and regional. The recurrence pattern did not differ between the 3D-RT- and IMRT-treated groups, while toxicities were reduced in the IMRT-treated group. All recurrences were within the high-risk planning target volume except for one case in IMRT. Conclusion: IMRT did not increase the risk of locoregional recurrence neither did it change the pattern of failure in patients with stage III-IV locally advanced HNSCC, although it did reduce toxicities.