Effectiveness and Toxicities of Intensity-Modulated Radiotherapy for Patients with Locally Recurrent Nasopharyngeal CarcinomaReport as inadecuate




Effectiveness and Toxicities of Intensity-Modulated Radiotherapy for Patients with Locally Recurrent Nasopharyngeal Carcinoma - Download this document for free, or read online. Document in PDF available to download.

Purpose

To analyze the effectiveness and toxicities in the re-irradiation of locally recurrent nasopharyngeal carcinoma NPC using intensity-modulated radiotherapy IMRT.

Methods

This is a retrospective analysis of 54 NPC patients with local recurrence re-irradiated with IMRT. The re-staging for rT1, rT2, rT3, rT4 were 3 5.6%, 8 14.8%, 9 16.7%, 34 63% respectively. The average dose to GTV was 69.95 Gy 49.8-76.58 Gy, the average BED3Gy was 116.8 Gy 83.5-127.9 Gy. V95 was 96%, and D95 was 65.75Gy. 33.3% of them received concurrent chemoradiotherapy.

Results

Median overall survival OS was 21 months 1-93 mon. The 1-, 2-year local progression free survival LPFS rate was 84.5%, 64% and OS rate was 71.7%, 44.3%. Severe late adverse events SLAE occurred in 48.1% of patients, including 31.5% with ulcer or necrosis of the nasopharyngeal mucosa, 20.4% with difficulty in feeding, 18.5% with temporal lobe necrosis, 11.1% with massive hemorrhage. 15.4% died of local regional progression, 5.8% died of distant metastasis, 25% died of SLAE, 9.6% died of both local regional progression and SLAE that could not be differentiated, 5.8% died of other medical complications. Concurrent chemoradiotherapy was the independent negative prognostic factors for LPFS; PTV>100 ml was a predictive factor of poor OS; patients with invasion of post-styloid space were at higher risk of SLAE.

Conclusions

The present study demonstrated that IMRT with 70Gy was efficient for local tumor control. However, we observed a high frequency of serious late complications. More optimized combination treatment and patient selection are required to achieve excellent local control without significant late morbidities in locally recurrent NPC.



Author: Hai-yan Chen , Xiu-mei Ma , Ming Ye, Yan-li Hou, Hua-Ying Xie, Yong-rui Bai

Source: http://plos.srce.hr/



DOWNLOAD PDF




Related documents