Allen Chen of UC Davis reported that the use of intensity-modulated radiation therapy, or IMRT, was associated with fewer long-term side effects, which led to a better quality of life. Standard radiation therapy to the head and neck has been known to affect a patient's ability to produce saliva, taste, and even chew food. These side effects historically have resulted in permanent disabilities.
"With the newer machines using IMRT, physicians are skilfully able to deliver higher doses of radiation to the tumour and lower doses to surrounding normal tissues than ever before," Chen said. "I wanted to see if this theoretical advantage resulted in any tangible improvements in quality of life for patients."
For the study, Chen used the University of Washington Quality of Life instrument, a standardised, previously validated questionnaire that patients complete after radiation therapy. The survey was administered prospectively to 155 patients at UC Davis Cancer Centre diagnosed with head and neck cancers, 54 per cent of whom were initially treated with IMRT and 46 per cent of whom were treated with other radiation therapy technologies. All of the patients receiving IMRT also underwent image-guided radiotherapy (IGRT), which has been available at UC Davis since 2006 and is used to increase accuracy by taking a high-quality scan of the tumour daily.
Chen and his colleagues found that the early gains observed in quality of life became magnified over time for those who received IMRT treatment. For example, one year after treatment, 51 per cent of the IMRT patients rated their quality of life as very good or outstanding, compared to 41 per cent of non-IMRT patients. But two years after treatment, the percentages changed to 73 per cent and 49 per cent respectively.
John Torres of Sacramento was diagnosed in early 2010 with a large tumour at the base of his tongue on the right side of his throat. Fearing that surgery might result in the loss of his voice box, Torres opted for IMRT with IGRT and had 33 treatments. Torres, now 73 and in remission, points out that the treatments were "no walk in the park," but said he is faring much better than he expected. Although his mouth is often dry and he has lost some taste sensation, he is enjoying an active life. "I golf a couple of time a week," he said. "My wife and I like to socialise. We go out, and we dance. And we are planning to take a cruise through the Panama Canal in next two or three months. Life has gotten back to pretty much exactly what it was."
Chen acknowledged that quality of life is difficult to measure because of its subjective nature. Nonetheless, he said the findings support the more widespread use of IMRT in radiation clinics throughout the country.
MEDICA.de; Source: University of California Davis