Study confirms advanced radiotherapy technique reduces side-effects for head and neck cancer patients

13 January 2011 - Treating head and neck cancer with advanced instead of conventional radiotherapy can improve quality of life and reduce a key side-effect, according to a new study led by the ICR.

The PARSPORT randomised Phase III trial compared intensity-modulated radiotherapy (IMRT) with standard radiotherapy, which can damage the major salivary glands and lead to dry mouth. A lack of saliva prevents patients from eating solid food and speaking normally, and can accelerate development of tooth decay.  

In contrast, IMRT can deliver precise radiation to tumours while minimising exposure to healthy surrounding tissues.

Between January 2003 and December 2007, 94 patients with squamous-cell carcinoma of the head and neck (HNSCC) were enrolled from six radiotherapy centres across the UK and randomly assigned to IMRT (47 patients) or conventional radiotherapy (47). The trial, led by the ICR’s Dr Chris Nutting and co-ordinated by the ICR’s Clinical Trials and Statistics Unit, was the largest randomised trial of IMRT in head and neck cancer to date.

Overall, patients treated with IMRT experienced significantly less dry mouth than those given conventional radiotherapy, had significantly better recovery of saliva flow, and a consistently higher quality of life score.

At 12 months, grade 2 or worse dry mouth was reported by 74 per cent of patients receiving conventional radiotherapy compared with 39 per cent given IMRT, and at 24 months in 83 per cent of patients versus 29 per cent.

At one year, unstimulated saliva flow was recorded in nearly half of patients in the IMRT group compared with none in the conventional radiotherapy group.