Safety and clinical outcome of intensity-modulated radiotherapy with simultaneous integrated boost versus sequential boost simultaneous integrated boost- intensity-modulated radiotherapy technique in head-and-neck cancer: A prospective comparative st

Background: Conventionally, sequential boost (SEQ) intensity-modulated radiation therapy (IMRT) for head-and-neck (H&N) cancer involved an initial elective irradiation followed by targeted, reduced-dose boost fields to achieve the necessary tumor control doses for both gross and subclinical disease while respecting organs at risk tolerances. In contrast, the simultaneous integrated boost (SIB) technique allows for the delivery of different dose levels to various target volumes within a single treatment plan. Aims and Objectives: Our comparative study focused on the clinical outcomes of the SIB technique using doses of 66 Gy, 60 Gy, and 54 Gy in 30 fractions over 6 weeks, Versus the SEQ boost technique using 70 Gy in 35 fractions over 7 weeks, in H&N cancer. Materials and Methods: This was a prospective comparative study conducted in the Department of Radiotherapy between March 2020 and September 2022. According to the inclusion and exclusion criteria, a total of 60 patients were included in this study. Results: In the SIB arm, complete response and partial response were 24 (80%) and 6 (20%), respectively. Similarly, in the SEQ arm, complete response and partial response were 23 (76%) and 7 (23%), respectively. The difference in response between the groups was not statistically significant (P=0.34, not significant (NS)). Conclusion: Both SIB-IMRT and SEQ-IMRT are acceptable options for radiotherapy in H&N cancer. However, SIB-IMRT might be the preferred technique as it involves a single, more convenient treatment plan.