Show simple item record

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.issued2018-11-01
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.publisherELSEVIER SCI LTD
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 Unit
icr.researchteamICR-CTSU Urology and Head and Neck Trials Team
icr.researchteamTargeted Therapy
dc.contributor.icrauthorBhide, Shreerang
dc.contributor.icrauthorEmson, Marie
dc.contributor.icrauthorHarrington, Kevin
dc.contributor.icrauthorSydenham, Mark
dc.contributor.icrauthorHall, Emma


Files in this item

Thumbnail

This item appears in the following collection(s)

Show simple item record

https://creativecommons.org/licenses/by/4.0
Except where otherwise noted, this item's license is described as https://creativecommons.org/licenses/by/4.0