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According to an article recently published in Radiation Oncology, Biology and Physics, intensity-modulated radiotherapy (IMRT) improves salivary flow and quality of life compared to conventional radiotherapy (CRT) for patients with early-stage nasopharyngeal cancer.

The nasopharynx is the area above the soft palate (roof of the mouth) and behind the nose. Nasopharyngeal cancer (NPC) is a type of head and neck cancer. Approximately 40,000 people in the U.S. are diagnosed with head and neck cancer every year.

Early NPC refers to cancer that has not spread from the site of origin to more distant sites in the body. Radiation therapy is often an integral part of treatment for early NPC. However, side effects from radiation therapy, such as xerostomia (dry mouth), are common. Patients may suffer from different degrees of xerostomia, which impair swallowing, chewing, eating, and speaking. Researchers continue to evaluate different ways to reduce xerostomia and other side effects from therapy.

Researchers from Hong Kong recently conducted a clinical trial to evaluate the effect of IMRT on the quality of life of patients with early NPC. IMRT involves the use of higher doses of radiation therapy directed toward the cancerous cells, with lower doses of radiation directed toward surrounding tissue. This is in contrast to CRT, which directs the same doses of radiation to a specified area, meaning surrounding healthy tissue receives the same dose of radiation as cancerous tissue.

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This trial included 51 patients. One group was treated with CRT, and the other group received IMRT.

  • At 12 months following radiation, saliva flow was at least 25% of pre-treatment levels in a significantly larger portion of patients treated with IMRT than CRT.
  • Bodily pain, physical function, and physical roles were rated significantly higher among patients treated with IMRT than CRT.
  • Patients treated with IMRT had increasing improvements in xerostomia-related symptoms; these improvemnts were not observed among patients treated with CRT.

The researchers concluded that IMRT reduces xerostomia among patients with early NPC treated with radiation therapy when compared to CRT. Patients with early NPC may wish to speak with their physician regarding their individual risks and benefits of all treatment options, including IMRT.

Reference: Pow E, Kwong D, McMillan A, et al. Xerostomia and Quality of Life After Intensity-Modulated Radiotherapy vs. Conventional Radiotherapy for Early-Stage Nasopharyngeal Carcinoma: Initial Report on a Randomized Controlled Clinical Trial. Radiation Oncology, Biology and Physics. 2006; 66: 981-991.