Abstract Background: Intensity-modulated radiation therapy (IMRT) has become the standard of care for the treatment of nasopharyngeal and oropharyngeal carcinoma. As the majority of head and neck IMRT is performed in community cancer centers, which often have lower volume than major academics centers, it is important to ensure that cancer control rates and patient survival are comparable between community treatment centers and large academic institutions with site-specific oncologists. Material and methods: From February 2003 to August 2008, 8 patients with nasopharyngeal carcinoma and 42 patients with oropharyngeal carcinoma were treated with IMRT at the National Naval Medical Center in Bethesda, Maryland. Results: At a median follow-up of 61 months, the overall survival (OS) was 89% and local control (LC) was 94% for all patients treated. Patients with nasopharyngeal cancer achieved 100% LC and a 5-year OS of 100% with a median follow-up of 64.5 months. Patients with oropharyngeal cancer achieved 93% LC (median time to loco-regional recurrence of 11 months) and an OS of 88% at a median follow-up of 58 months. All patients with LC at 18 months remained free of loco-regional failure throughout the follow-up period. Conclusions: Institutional reviews from large academic centers provide encouraging results regarding the efficacy and delivery of IMRT in the treatment of head and neck cancer. This retrospective, single-institution analysis demonstrates the ability to effectively implement and utilize IMRT in the treatment of head and neck cancer in an environment with relatively modest patient volume. The excellent OS and LC outcomes at our institution confirm the potential for smaller academic and community centers with lower head and neck patient volume to deliver effective therapy despite the inherent complexity of IMRT.
Keywords: head and neck; IMRT; oropharynx; nasopharynx