Nelie, In the M.D. Anderson 2004 study involving 74 patients with oropahyngeal cancer (BOT, tonsils, or soft palate) , 43 patients (88% St III/IV) were given postoperative IMRT (of whom only 3 were given chemo). 31 patients (100% St III/IV) were given definitive (no surgery) IMRT (of whom 17 were given chemo). The postoperative group had such good results, it would have been hard to get an improvement from chemo I think (4 yr disease free survival 92%, 4-yr locoregional control 95%, distant metastis-free survival (94%). The definitive IMRT group had worse rates overall (66%,78%,84%) but within that the chemo group had better DMFS survival (by 13%) though the others ratings were about the same.

The Univ of Iowa study covered all head-and-neck cancer of which the oropharyngeal patients had the best outcomes (2-yr 98% local-regional control rate). They say that IMRT has been shown to potentially improve local-regional control, reduce side effects, and improve QOL - but that long-term outcome data of IMRT are limited. It goes on to talk about differences in IMRT delivery techniques, which make it hard to reliably reproduce the same results.

In both studies, they compared a group having post-operative IMRT who didn't get chemo with a definitive IMRT group of whom about 50% got chemo.

It seems very promising to me. I'd like to think progress is being made.

Connie