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RTOG Study Finds Less Salivary Gland Toxicity in Patients Treated with IMRT for Oropharyngeal Cancer

Boston – A multicenter trial testing intensity-modulated radiation therapy (IMRT) for patients with early stage oropharyngeal cancer showed a reduction in long-term salivary toxicity while achieving good tumor control according to new research from the Radiation Therapy Oncology Group (RTOG) presented at the American Society for Therapeutic Radiology and Oncology (ASTRO) 50th Annual Meeting in Boston. RTOG, an NCI-funded national clinical trials group, is a clinical research component of the American College of Radiology (ACR).
RTOG launched its phase I/II trial, RTOG 0022, to determine whether standardized dose and target definitions for IMRT could be accomplished in a multicenter setting. A total of 69 patients were entered on study from February 2001 through January 2005 from 14 academic and community institutions in the United States and Canada. A two-year local-regional control rate of 91 percent and a 49 percent rate of acute salivary gland toxicity (Grade ³ 2) was reported by investigators compared with 80 and 84 percent in the same patient population from the RTOG database. The rate of salivary gland toxicity dropped to 23% at one year and 13 percent at two years. Evaluable patients who, at central review of their treatment plan, where found to have a major variation in their radiotherapy treatment plan had a significantly higher rate of local-regional failure than patients who were treated according to protocol (50 vs. 6 percent).

“This study was the work of many physicians and physicists to establish the rules for IMRT doses and quality assurance, at a time, 1999-2000, when IMRT was in its infancy and very few institutions started treating patients with it,” related Avraham Eisbruch, MD, lead author and study chair from the University of Michigan Health Systems, Ann Arbor, MI.

All institutions participating in the trial were pre-approved for IMRT by the Image-guided Therapy QA Center (ITC) at Washington University in St. Louis.

For more information or to arrange an interview with an RTOG spokesperson, please contact Sharon Hartson at 609.458.5604, shartson@phila.acr.org or visit RTOG at booth 2247.

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ASTRO Abstract #219, Multi-institutional Trial of IMRT for Early Oropharyngeal Cancer: Acceleration via Simultaneously Incorporated Boost (SIB) (RTOG 0022), is available at http://www.redjournal.org/article/S0360-3016(08)01207-8/fulltext.

Information about RTOG is available at www.rtog.org.

In addition to Dr. Eisbruch, authors include: J. Harris, Radiation Therapy Oncology Group, Philadelphia, PA; A. Garden and K Ang, MD Anderson Cancer Center, Houston, TX; C. Chao and W. Bosch, Washington University St Louis, St Louis, MO; W. Straube, Image-Guided Therapy Center, St. Louis, MO; P. Harari, University of Wisconsin, Madison, WI; G. Sanguineti, University of Texas Medical Branch, Galveston, TX; and, C. Jones, Radiation Oncology Center, Sacramento, CA. The research was funded by National Cancer Institute grants CA21661, CA37422, and 32115.

The Radiation Therapy Oncology Group (RTOG) is a clinical research enterprise of the American College of Radiology (ACR), located in the ACR Philadelphia, PA office. RTOG is a multi-institutional international clinical cooperative group funded primarily by National Cancer Institute grants CA21661, CA32115 and CA37422. RTOG has 40 years of experience in conducting clinical trials and is comprised of over 300 major research institutions in the United States, Canada, and internationally. The group currently is currently accruing to 40 studies that involve radiation therapy alone or in conjunction with surgery and/or chemotherapeutic drugs or which investigate quality of life issues and their effects on the cancer patient.

The American College of Radiology (ACR) is a national professional organization serving more than 32,000 radiologists, radiation oncologists, interventional radiologists and medical physicists with programs focusing on the practice of radiology and the delivery of comprehensive health care services.

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