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There is still only limited experience with IMRT using simultaneously integrated boost (SIB-IMRT) in the head and neck region in terms of normal tissue response.<\/jats:p>\n            <jats:p>The aim of this work was (1) to establish tumor response in HNC patients treated with SIB-IMRT, and (2) to assess tissue tolerance following different SIB-IMRT schedules.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Between 1\/2002 and 12\/2004, 115 HNC patients have been curatively treated with IMRT. 70% received definitive IMRT (dIMRT), 30% were postoperatively irradiated. In 78% concomitant chemotherapy was given.<\/jats:p>\n            <jats:p>SIB radiation schedules with 5\u20136 \u00d7 2 Gy\/week to 60\u201370 Gy, 5 \u00d7 2.2 Gy\/week to 66\u201368.2 Gy (according to the RTOG protocol H-0022), or 5 \u00d7 2.11 Gy\/week to 69.6 Gy were used.<\/jats:p>\n            <jats:p>After mean 18 months (10\u201344), 77% of patients were alive with no disease. Actuarial 2-year local, nodal, and distant disease free survival was 77%, 87%, and 78%, respectively. 10% were alive with disease, 10% died of disease. 20\/21 locoregional failures occurred inside the high dose area. Mean tumor volume was significantly larger in locally failed (63 cc) vs controlled tumors (32 cc, p &lt;0.01), and in definitive (43 cc) vs postoperative IMRT (25 cc, p &lt;0.05); the locoregional failure rate was twofold higher in definitively irradiated patients.<\/jats:p>\n            <jats:p>Acute reactions were mild to moderate and limited to the boost area, the persisting grade 3\/4 late toxicity rate was low with 6%. The two grade 4 reactions (dysphagia, laryngeal fibrosis) were observed following the SIB schedule with 2.2 Gy per session.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>SIB-IMRT in HNC using 2.0, 2.11 or 2.2 Gy per session is highly effective and safe with respect to tumor response and tolerance. SIB with 2.2 Gy is not recommended for large tumors involving laryngeal structures.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/1748-717x-1-7","type":"journal-article","created":{"date-parts":[[2006,4,19]],"date-time":"2006-04-19T12:26:39Z","timestamp":1145449599000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":70,"title":["IMRT using simultaneously integrated boost (SIB) in head and neck cancer patients"],"prefix":"10.1186","volume":"1","author":[{"given":"G","family":"Studer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"PU","family":"Huguenin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JB","family":"Davis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G","family":"Kunz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"UM","family":"L\u00fctolf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"Glanzmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2006,3,31]]},"reference":[{"key":"7_CR1","doi-asserted-by":"publisher","first-page":"1117","DOI":"10.1016\/S0360-3016(99)00550-7","volume":"46","author":"LA Dawson","year":"2000","unstructured":"Dawson LA, Anzai Y, Marsh L, Martel MK, Paulino A, Ship JA, Eisbruch A: Patterns of local-regional recurrence following parotid-sparing conformal and segmental intensity-modulated radiotherapy for head and neck cancer. 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