Long-term results of 934 nasopharyngeal carcinoma treated with radiotherapy alone

( views:109, downloads:0 )
Author:
CHEN Chun-yan(State Key Laboratory of Oncology in Southern China, Department of Radiation Oncology , Cancer Center, Sun Yat-sen University, Guangzhou 510060, China)
HAN Fei(State Key Laboratory of Oncology in Southern China, Department of Radiation Oncology , Cancer Center, Sun Yat-sen University, Guangzhou 510060, China)
ZHAO Chong(State Key Laboratory of Oncology in Southern China, Department of Radiation Oncology , Cancer Center, Sun Yat-sen University, Guangzhou 510060, China)
LU Li-xia(State Key Laboratory of Oncology in Southern China, Department of Radiation Oncology , Cancer Center, Sun Yat-sen University, Guangzhou 510060, China)
WU Shao-xiong(State Key Laboratory of Oncology in Southern China, Department of Radiation Oncology , Cancer Center, Sun Yat-sen University, Guangzhou 510060, China)
LU Tai-xiang(State Key Laboratory of Oncology in Southern China, Department of Radiation Oncology , Cancer Center, Sun Yat-sen University, Guangzhou 510060, China)
Journal Title:
CHINESE JOURNAL OF RADIATION ONCOLOGY
Issue:
Volume 17, Issue 06, 2008
DOI:
Key Word:
Nasopharyngeal neoplasms/radiotherapy;Conventional radiotherapy;Prognosis

Abstract: Objective To evaluate the long-term efficaey of radiotherapy (RT) alone for nasopharyngnal eareinoma(NPC). Methods 934 NPC patients initially treated by conventional RT alone in 1999 were reviewed retrespeetively, including 676 males and 258 females. According to 92' Fuzhou staging system,there were 35 stage Ⅰ,215 stage Ⅱ ,488 stage Ⅲ and 196 stage Ⅳ diseases. All patients were treated by conventional RT alone with two opposing parallel faeio-eervical fields. The total dose delivered to the nasopharynx was 66-88 Gy. The dose to the cervical lymph nodes was 60-70 Gy, while the prophylactic dose to the neck was 50-56 Gy. Results The median follow-up was 67.1 months. The 5- and 8-year overall survival(OS), disease-free sutural, relapse-free survival and metastasis-free survival rates were 68.30%, 67.3% ,64.4% ,72.4% ,and 48.0% ,66.6% ,50.8% ,68.0% (χ2=49.74, P=0.000), respectively. For stage N1patients,the 5-and 8-year overall survival(OS) ,disease-free survival ,relapse-free survival and metastasis-free survival rates were significantly lower than those of stage NO patients [66.0% : 77.4% and 50.3%:59.8%(χ2=33.34,P=0.000);66.8%:76.1% and 66.1%:76.1%(χ2=29.08,P=0.000); 63.4%:72.9% and 48.9% : 58.7% (χ227.65,P=0.000);71.0%:80.8% and 63.4%:68.0%(χ2=26.13,P=0.000)]. And the corresponding rates of stage N<1-2>were significantly higher than stage N3,while no statistical difference was observed between stage N1 and N2. Multivariate analysis showed that sex, age, pathology,T stage and N stage were independent prognisitie factors for OS. Conclusions Radical RT alone could obtain good long-term results in early stage NPC. Tlowever,OS for local-regionally advanced stage NPC was still unsatisfactory because of the high relapse and metastatic rate. Clinical stage and N stage were valuable prognostic factors.

  • [1]Lee AWM,Poon YF,Foo W,et al.Retrospective analysis of 5037 patients with nasopharyngeal carcinoma treated during 1976-1985:overall survival and patterns of failure,Int J Radiat Oncol Biol Phys,1992,23:261-270.
  • [2]张宜勤,魏宝清.20年来鼻咽癌放射治疗疗效仝而提高的原因分析.中华放射肿瘤学杂志,1999,8:73-76.
  • [3]Zhang EP,Lian PG,Cai KL,et al.Radiation therapy of nasopharyngeal carcinoma:prognostic factors based on a 10-year follow-up of 1302 patients.Int J Radiat Oneol Biol Phys,1989,16:301-305.
  • [4]Emami B,Sethi A,Petruzzelli CJ.Influence of MRI on target volume delineation and IMRT planning in nasopharyngeal carcinoma.lnt J Radiat Oneol Biol Phys,2003,57:481-488.
  • [5]Chung NN,Ting LL,Hsu WC,et al.Impact of magnetic resonance imaging versus CT on nasopharyngeal carcinoma:primary tumor target delineation for radiotherapy.Head Neck,2004,26:241-246.
  • [6]Yeh SA,Tang Y,Lui CC,et al.Treatment outcomes and late complications of 849 patients with nasopharyngeal carcinoma treated with radiotherapy alone.Int J Radiat Oncol Biol Phys,2005,62:672-679.
  • [7]Leung TW,Tung SY,Sze WK,et al.Treatment results of 1070 patients with nasopharyngeal cancinoma:an analysis of survival and failure patterns.Head Neck,2005,27:555-565.
  • [8]Lee AW,Sze WM,Au JS,et al.Treatment results for nasopharyngeal carcinoma in the modem era:the ttong Kong experience.Int J Radiat Oneoi Biol Phys,2005,61:1107-1116.
  • [9]Al-Sarraf M,LeBlanc M,Gin P G S,et al.Chermotherapy versus radiotherapy in patients with advanced nasopharyngeal cancer:phase Ⅲ randomized Intergroup Study 0099.J Clin Oncol,1998,16:1310-1317.
  • [10]Langeedijk JA,Leemaus ChR,Buter J,et al.The additional value of chemotherapy to radiotherapy in locally advanced nasopharyngeal carcinoma:a meta-analysis of the published literature.J Clin Oncol,2004,22:4604-4612.
  • [11]Huncharek M,Kupelniek B.Combined chemoradiation versus radiation therapy alone in locally advanced nasopharyngeal carcinoma:results ofa meta-analysis of 1,528 patients from six randomized trials.Am J Clin Oncol,2002,25:219-223.
  • [12]Thephamongkhol K,Zhou J,Browman G,et al.Chemoradiotherapy versus radiotherapy alone for nasopharyngeal carcinoma:a meta-analysis of 78 randomized controlled trials(RCTs) from English and non-English databases.Proc Am Soc Clin Oncol,2004,22:491.
  • [13]魏宝清.从鼻咽癌放疗后颅神经放射损伤探讨当前放疗技术问题.中华放射肿瘤学杂志,1994,3:164-168.
  • [14]Kam MK,Leung SF,Zee B,et al.Prospoctive randomized study of intensity-modulated radiotherapy on salivary gland function in early-stage nasopharyngeal carcinoma patients.J Clin Oncol,2007,25:4873-4879.
  • [15]Chau RM,Teo PM,Kam MK,et al.Dosimetric comparison between2-dimeusional radiation therapy and intensity modulated radiation therapy in treatment of advanced T-stage nasopharyngeal carcinoma:to treat less or more in the planning organ-at-risk volume of the brainstem and spinal cord.Med Dosim,2007,32:263-270.
  • [16]Guerrero-Urbano MT,Clark CH,Kong C,et al.Target volume definition for head and neck intensity modulated radiotherapy:preclinical evaluation of PARSPORT trial guidelines.Clin Oncul,2007,19:604-613.
WanfangData CO.,Ltd All Rights Reserved
About WanfangData | Contact US
Healthcare Department, Fuxing Road NO.15, Haidian District Beijing, 100038 P.R.China
Tel:+86-010-58882616 Fax:+86-010-58882615 Email:yiyao@wanfangdata.com.cn