dc.contributor.author | Nutting, CM | |
dc.contributor.author | Morden, JP | |
dc.contributor.author | Beasley, M | |
dc.contributor.author | Bhide, S | |
dc.contributor.author | Cook, A | |
dc.contributor.author | De Winton, E | |
dc.contributor.author | Emson, M | |
dc.contributor.author | Evans, M | |
dc.contributor.author | Fresco, L | |
dc.contributor.author | Gollins, S | |
dc.contributor.author | Gujral, D | |
dc.contributor.author | Harrington, K | |
dc.contributor.author | Joseph, M | |
dc.contributor.author | Lemon, C | |
dc.contributor.author | Luxon, L | |
dc.contributor.author | van den Blink, Q | |
dc.contributor.author | Mendes, R | |
dc.contributor.author | Miah, A | |
dc.contributor.author | Newbold, K | |
dc.contributor.author | Prestwich, R | |
dc.contributor.author | Robinson, M | |
dc.contributor.author | Sanghera, P | |
dc.contributor.author | Simpson, J | |
dc.contributor.author | Sivaramalingam, M | |
dc.contributor.author | Srihari, NN | |
dc.contributor.author | Sydenham, M | |
dc.contributor.author | Wells, E | |
dc.contributor.author | Witts, S | |
dc.contributor.author | Hall, E | |
dc.contributor.author | COSTAR Investigators, | |
dc.date.accessioned | 2018-11-07T10:11:26Z | |
dc.date.issued | 2018-11-01 | |
dc.identifier.citation | European journal of cancer (Oxford, England : 1990), 2018, 103 pp. 249 - 258 | |
dc.identifier.issn | 0959-8049 | |
dc.identifier.uri | https://repository.icr.ac.uk/handle/internal/2918 | |
dc.identifier.eissn | 1879-0852 | |
dc.identifier.doi | 10.1016/j.ejca.2018.08.006 | |
dc.description.abstract | PURPOSE: 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.format | Print-Electronic | |
dc.format.extent | 249 - 258 | |
dc.language | eng | |
dc.language.iso | eng | |
dc.publisher | ELSEVIER SCI LTD | |
dc.rights.uri | https://creativecommons.org/licenses/by/4.0 | |
dc.subject | COSTAR Investigators | |
dc.subject | Humans | |
dc.subject | Parotid Neoplasms | |
dc.subject | Adult | |
dc.subject | Aged | |
dc.subject | Aged, 80 and over | |
dc.subject | Middle Aged | |
dc.subject | Female | |
dc.subject | Male | |
dc.subject | Radiotherapy, Intensity-Modulated | |
dc.subject | Young Adult | |
dc.title | Results 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.type | Journal Article | |
dcterms.dateAccepted | 2018-08-02 | |
rioxxterms.versionofrecord | 10.1016/j.ejca.2018.08.006 | |
rioxxterms.licenseref.uri | https://creativecommons.org/licenses/by/4.0 | |
rioxxterms.licenseref.startdate | 2018-11 | |
rioxxterms.type | Journal Article/Review | |
dc.relation.isPartOf | European journal of cancer (Oxford, England : 1990) | |
pubs.notes | Not 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-status | Published | |
pubs.volume | 103 | |
pubs.embargo.terms | Not known | |
icr.researchteam | Clinical Trials & Statistics Unit | |
icr.researchteam | ICR-CTSU Urology and Head and Neck Trials Team | |
icr.researchteam | Targeted Therapy | |
dc.contributor.icrauthor | Bhide, Shreerang | |
dc.contributor.icrauthor | Emson, Marie | |
dc.contributor.icrauthor | Harrington, Kevin | |
dc.contributor.icrauthor | Sydenham, Mark | |
dc.contributor.icrauthor | Hall, Emma | |