Long-term results of nasopharyngeal carcinoma patients treated with intensity-modulated radiotherapy alone

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Author:
SU Sheng-fa(Department of Radiation Oncology, Cancer Center of Sun Yat-Sen University, State Key Laboratory of Oncology in Southern China, Guangzhou 510060, China)
ZHAO Chong(Department of Radiation Oncology, Cancer Center of Sun Yat-Sen University, State Key Laboratory of Oncology in Southern China, Guangzhou 510060, China)
HAN Fei(Department of Radiation Oncology, Cancer Center of Sun Yat-Sen University, State Key Laboratory of Oncology in Southern China, Guangzhou 510060, China)
CHEN Chun-yan(Department of Radiation Oncology, Cancer Center of Sun Yat-Sen University, State Key Laboratory of Oncology in Southern China, Guangzhou 510060, China)
XIAO Wei-wei(Department of Radiation Oncology, Cancer Center of Sun Yat-Sen University, State Key Laboratory of Oncology in Southern China, Guangzhou 510060, China)
LI Jia-xin(Department of Radiation Oncology, Cancer Center of Sun Yat-Sen University, State Key Laboratory of Oncology in Southern China, Guangzhou 510060, China)
LU Tai-xiang(Department of Radiation Oncology, Cancer Center of Sun Yat-Sen University, State Key Laboratory of Oncology in Southern China, Guangzhou 510060, China)
Journal Title:
CHINESE JOURNAL OF RADIATION ONCOLOGY
Issue:
Volume 20, Issue 01, 2011
DOI:
10.3760/cma.j.issn.1004-4221.2011.01.001
Key Word:
Nasopharyngeal neoplasms/radiotherapy;Radiotherapy, intensity-modulated;Prognosis

Abstract: Objective To evaluate the outcomes and toxicities of early stage nasopharyngeal carcinoma(NPC)patients treated with intensity-modulated radiotherapy(IMRT)alone. Methods From February 2001 to January 2008, 198 early stage NPC patients according to AJCC/UICC 2002 staging system were treated by radical radiotherapy with IMRT technique in our institute, the clinical data were analyzed retrospectively. Results The 5-year disease-specific survival, local recurrence-free survival(LRFS)and distant metastasis-free survival(DMFS)were 97.3%, 97.7% and 97. 8% respectively. The 5-year LRFS for T1, T2 patients were 100%, 96. 7%(x2 = 2. 24 ,P = 0. 135)respectively. The 5-year DMFS for T1 N0,T2N0, T1N1, and T2N1 patients were 100%, 98. 8%, 100% and 93. 8%(x2= 2. 35, P= 0. 125)respectively. Grade 1 and 2 mucositis and pharyngitis were most common acute toxicities. Radiation encephalopathy and cranial nerve injury were not observed in all patients. Conclusions IMRT alone for early stage NPC patients can produce satisfactory results and acceptable treatment-relative toxicities. Patients with T2b and T2bN1 had a relatively higher incidence of local recurrence and distant metastasis, which suggested that combination of IMRT and chemotherapy may improve clinical results in those patients.

  • [1]Xiao WW,Han F,Lu TX,et al.Treatment outcomes after radiotherapy alone for patients with early-stage nasopharyngeal carcinoma.Int J Radiat Oncol Biol Phys,2009,74:1070-1076.
  • [2]Song CH,Wu HG,Heo DS,et al.Treatment outcomes for radiotherapy alone are comparable with neoadjuvant chemotherapy followed by radiotherapy in early-stage nasopharyngeal carcinoma.Laryngoscope,2008,118:663-670.
  • [3]Chua DF,Sham JS,Kwong DL,et al.Treatment outcome after radiotherapy alone for patients with stage Ⅰ-Ⅱ nasopharyngeal carcinoma.Cancer,2003,98:74-80.
  • [4]高黎,易俊林,黄晓东,等.鼻咽癌根治性放疗10年经验总结.中华放射肿瘤学杂志,2006,15:249-256.
  • [5]宗井凤,马骏,唐玲珑,等.鼻咽癌综合治疗策略研究-749例疗效分析.中国肿瘤,2005,14:538-542.
  • [6]Kwong DL,Pow EH,Sham JS,et al.Intensity-modulated radiotherapy for early-stage nasopharyngeal carcinoma:a prospective study on disease control and preservation of salivary function.Cancer,2004,101:1584-1593.
  • [7]赵充,卢泰样,韩非,等.139例鼻咽癌调强放疗的临床研究.中华放射肿瘤学杂志,2006,15:1-6.
  • [8]Butler EB,Teh BS,Grant WH,et al.Smart(simultaneous modulated accelerated radiation therapy)boost:a new accelerated fractionation schedule for the treatment of head and neck cancer with intensity modulated radiotherapy.Int J Radiat Oncol Biol Phys,1999,45:21-32.
  • [9]陈存燕,卢泰祥,赵充,等.T3~T4 N0~N3期鼻咽癌单纯放疗疗效分析.中华放射肿瘤学杂志,2006.15:77-80.
  • [10]易俊林,高黎,黄晓东,等.临床Ⅱ期鼻咽癌根治性常规分割放疗预后分析.中华放射肿瘤学杂志,2009,18:83-86.
  • [11]Wong FC,Ng AW,Lee VH,et al.Whole-field simultaneous integrated-boost intensity-modulated radiotherapy for patients with nasopharyngeal carcinoma.Int J Radiat Oncol Biol Phys,2010,76:138-145.
  • [12]Ma J,Liu L,Tang L,et al.Retropharyngeal lymph node metastasis in nasopharyngeal carcinoma:prognostic value and staging categories.Clin Cancer Res,2007,13:1445-1452.
  • [13]Tham IW,Hee SW,Yap SP,et al.Retropharyngeal nodal metastasis related to higher rate of distant metastasis in patients with N0 and N1 nasopharyngeal cancer.Head Neck,2009,31:468-474.
  • [14]中国鼻咽癌临床分期工作委员会.鼻咽癌'92分期修订工作报告.中华放射肿瘤学杂志,2009,18:2-6.
  • [15]International Union Against Cancer.TNM classification of malignant tumors[2010-02-22].http://www.uicc.org/templates/uicc/ pdf/ tnm/091209_tnm_7 th_edition_summary.pdf.
  • [16]Teo P,Yu P,Lee WY,et al.Significant prognosticators after primary radiotherapy in 903 nondisseminated nasopharyngeal carcinoma evaluated by computer tomography.Int J Radiat Oncol Biol Phys,1996,36:291-304.
  • [17]张典刚,卢泰祥,陈春燕,等.鼻咽癌咽旁间隙受侵对远处转移影响的研究.中华肿瘤防治杂志,2008,15:541-543.
  • [18]Tham IW,Hee SW,Yeo RM,et al.Treatment of nasopharyngeal carcinoma using intensity-modulated radiotherapy-the national cancer centre Singapore experience.Int J Radiat Oncol Biol Phys,2009,75:1481-1486.
  • [19]Lee AW,Sze WM,Au JS,et al.Treatment results for nasopharyngeal carcinoma in the modern era:the Hong Kong experience.Int J Radiat Oncol Biol Phys,2005,61:1107-1116.
  • [20]刘雅洁,易俊林,欧阳汉,等.鼻咽癌放射治疗后放射性脑病的MRI表现.中华放射肿瘤学杂志,2000,9:225-228.
  • [21]Chua DT,Ma J,Sham JS,et al.Improvement of survival after addition of induction chemotherapy to radiotherapy in patients with early-stage nasopharyngeal carcinoma:Subgroup analysis of two Phase Ⅲ trials.Int J Radiat Oncol Biol Phys,2006,65:1300-1306.
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