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dc.contributor.authorNutting, CM
dc.contributor.authorMorden, JP
dc.contributor.authorBeasley, M
dc.contributor.authorBhide, S
dc.contributor.authorCook, A
dc.contributor.authorDe Winton, E
dc.contributor.authorEmson, M
dc.contributor.authorEvans, M
dc.contributor.authorFresco, L
dc.contributor.authorGollins, S
dc.contributor.authorGujral, D
dc.contributor.authorHarrington, K
dc.contributor.authorJoseph, M
dc.contributor.authorLemon, C
dc.contributor.authorLuxon, L
dc.contributor.authorvan den Blink, Q
dc.contributor.authorMendes, R
dc.contributor.authorMiah, A
dc.contributor.authorNewbold, K
dc.contributor.authorPrestwich, R
dc.contributor.authorRobinson, M
dc.contributor.authorSanghera, P
dc.contributor.authorSimpson, J
dc.contributor.authorSivaramalingam, M
dc.contributor.authorSrihari, NN
dc.contributor.authorSydenham, M
dc.contributor.authorWells, E
dc.contributor.authorWitts, S
dc.contributor.authorHall, E
dc.contributor.authorCOSTAR Investigators
dc.date.accessioned2018-11-07T10:11:26Z
dc.date.issued2018-11
dc.identifier.citationEuropean journal of cancer (Oxford, England : 1990), 2018, 103 pp. 249 - 258
dc.identifier.issn0959-8049
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/2918
dc.identifier.eissn1879-0852
dc.identifier.doi10.1016/j.ejca.2018.08.006
dc.description.abstractPurpose About 40-60% of patients treated with post-operative radiotherapy for parotid cancer experience ipsilateral sensorineural hearing loss. Intensity-modulated radiotherapy (IMRT) can reduce radiation dose to the cochlea. COSTAR, a phase III trial, investigated the role of cochlear-sparing IMRT (CS-IMRT) in reducing hearing loss.Methods Patients (pT1-4 N0-3 M0) were randomly assigned (1:1) to 3-dimensional conformal radiotherapy (3DCRT) or CS-IMRT by minimisation, balancing for centre and radiation dose of 60Gy or 65Gy in 30 daily fractions. The primary end-point was proportion of patients with sensorineural hearing loss in the ipsilateral cochlea of ≥10 dB bone conduction at 4000 Hz 12 months after radiotherapy compared using Fisher's exact test. Secondary end-points included hearing loss at 6 and 24 months, balance assessment, acute and late toxicity, patient-reported quality of life, time to recurrence and survival.Results From Aug 2008 to Feb 2013, 110 patients (54 3DCRT; 56 CS-IMRT) were enrolled from 22 UK centres. Median doses to the ipsilateral cochlea were 3DCRT: 56.2Gy and CS-IMRT: 35.7Gy (p < 0.0001). 67/110 (61%) patients were evaluable for the primary end-point; main reasons for non-evaluability were non-attendance at follow-up or incomplete audiology assessment. At 12 months, 14/36 (39%) 3DCRT and 11/31 (36%) CS-IMRT patients had ≥10 dB loss (p = 0.81). No statistically significant differences were observed in hearing loss at 6 or 24 months or in other secondary end-points including patient-reported hearing outcomes.Conclusion CS-IMRT reduced the radiation dose below the accepted tolerance of the cochlea, but this did not lead to a reduction in the proportion of patients with clinically relevant hearing loss.
dc.formatPrint-Electronic
dc.format.extent249 - 258
dc.languageeng
dc.language.isoeng
dc.rights.urihttps://creativecommons.org/licenses/by/4.0
dc.subjectCOSTAR Investigators
dc.subjectHumans
dc.subjectParotid Neoplasms
dc.subjectAdult
dc.subjectAged
dc.subjectAged, 80 and over
dc.subjectMiddle Aged
dc.subjectFemale
dc.subjectMale
dc.subjectRadiotherapy, Intensity-Modulated
dc.subjectYoung Adult
dc.titleResults of a multicentre randomised controlled trial of cochlear-sparing intensity-modulated radiotherapy versus conventional radiotherapy in patients with parotid cancer (COSTAR; CRUK/08/004).
dc.typeJournal Article
dcterms.dateAccepted2018-08-02
rioxxterms.versionofrecord10.1016/j.ejca.2018.08.006
rioxxterms.licenseref.urihttps://creativecommons.org/licenses/by/4.0
rioxxterms.licenseref.startdate2018-11
rioxxterms.typeJournal Article/Review
dc.relation.isPartOfEuropean journal of cancer (Oxford, England : 1990)
pubs.notesNot known
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Cancer Biology
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Cancer Biology/Targeted Therapy
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies/Clinical Trials & Statistics Unit
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies/ICR-CTSU Urology and Head and Neck Trials Team
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Targeted Therapy
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Cancer Biology
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Cancer Biology/Targeted Therapy
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies/Clinical Trials & Statistics Unit
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies/ICR-CTSU Urology and Head and Neck Trials Team
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Targeted Therapy
pubs.publication-statusPublished
pubs.volume103
pubs.embargo.termsNot known
icr.researchteamClinical Trials & Statistics Uniten_US
icr.researchteamICR-CTSU Urology and Head and Neck Trials Teamen_US
icr.researchteamTargeted Therapyen_US
dc.contributor.icrauthorMorden, James Peteren
dc.contributor.icrauthorSydenham, Marken
dc.contributor.icrauthorHarrington, Kevinen
dc.contributor.icrauthorHall, Emmaen


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