Evidence map›Paper›PMID 37029424›Full record

ArticleRadiation oncology (London, England)2023

Dose escalation in oropharyngeal cancer: a comparison of simultaneous integrated boost and brachytherapy boost.

Anna Embring, Eva Onjukka, Claes Mercke, Ingmar Lax, Anders Berglund, Signe Friesland

Open access · goldAbstract readComparative Study
In one paragraph

Article in Radiation oncology (London, England), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
2.4field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 7 citations in OpenAlex.

  1. Patient-reported outcomes in oropharyngeal cancer: comparing two cohorts with different treatment protocols.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
    Article
  2. Long-term outcomes among individuals living with and beyond head and neck cancer: a scoping review.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
    Article
  3. HPV-driven cancer: from epidemiology to the HPV-driven tumor board proposal, everything you wanted to know but were afraid to ask.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2025
    Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Anna EmbringDepartment of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden. anna.embring@ki.se.
Eva OnjukkaDepartment of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.
Claes MerckeDepartment of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.
Ingmar LaxDepartment of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.
Anders BerglundEpistat Epidemiology and Statistics Consulting, Uppsala, Sweden.
Signe FrieslandDepartment of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.
Karolinska Institutet · SE

Funding

Stiftelsen Konung Gustaf V:s Jubileumsfond 164082
6 · The paper itself

Abstract

backgroundLocal recurrence is the most common pattern of failure in head and neck cancer. It can therefore be hypothesised that some of these patients would benefit from an intensified local treatment, such as radiation dose escalation of the primary tumour. This study compares treatment and toxicity outcomes from two different boost modalities in oropharyngeal cancer: simultaneous integrated boost (SIB) and brachytherapy boost.

methodsTwo hundred and forty-four consecutive patients treated with > 72 Gy for oropharyngeal squamous cell carcinoma between 2011 and 2018 at our institution were retrospectively analysed. Data on side effects were collected from a local quality registry and supplemented with a review of medical records. Patients receiving a brachytherapy boost first had external beam radiotherapy consisting of 68 Gy in 2 Gy fractions to the gross tumour volume (GTV), and elective radiotherapy to the neck bilaterally. The brachytherapy boost was typically given using pulsed dose rate, 15 fractions and 0.56-0.66 Gy per fraction [total dose in EQD2 = 75.4-76.8 Gy (α/β = 10)]. The typical dose escalated radiotherapy with external beam radiotherapy only, was delivered using SIB with 74,8 Gy in 2.2 Gy fractions [EQD2 = 76.0 Gy (α/β = 10)] to the primary tumour, 68 Gy in 2 Gy fractions to GTV + 10 mm margin and elective radiotherapy to the neck bilaterally.

resultsDose escalation by SIB was given to 111 patients and brachytherapy boost to 134 patients. The most common type of cancer was base of tongue (55%), followed by tonsillar cancer (42%). The majority of patients had T3- or T4-tumours and 84% were HPV-positive. The 5-year OS was 72,4% (95% CI 66.9-78.3) and the median follow-up was 6.1 years. Comparing the two different dose escalation modalities we found no significant differences in OS or PFS and these results remained after a propensity-score matched analysis was performed. The analysis of grade ≥ 3 side effects showed no significant differences between the two different dose escalation techniques.

conclusionsWe found no significant differences in survival or grade ≥ 3 side effects comparing simultaneous integrated boost and brachytherapy boost as alternative dose escalation modalities in the treatment of oropharyngeal cancer.

Indexed as

BrachytherapyOropharyngeal NeoplasmsRadiotherapy DosageSquamous Cell Carcinoma of Head and NeckHead and Neck NeoplasmsHumansNeoplasm Recurrence, LocalNeoplasm StagingRetrospective StudiesBrachytherapyDose escalationHead and neck cancerOropharyngeal cancerRadiotherapySide effectsSimultaneous integrated boost

Identifiers

PMID37029424
PMCPMC10082532
OpenAlexW4362697454

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.