Xiayun He1, Ming Ye2, Xiaomao Guo3, Ziqiang Pan1, Zhen Zhang1, Shaoqin He1, Taifu Liu1. 1. Department of Radiation Oncology, Fudan University, Shanghai Cancer Center, Shanghai 200032, PR China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, PR China. 2. Department of Radiation Oncology, Renji Hospital, Medical School of Shanghai Jiaotong University, Shanghai, PR China. 3. Department of Radiation Oncology, Fudan University, Shanghai Cancer Center, Shanghai 200032, PR China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, PR China. Electronic address: xiaomaoguosh@yahoo.cn.
Abstract
OBJECTIVES: To follow up the efficacy and incidence of radiation-induced complications of late course accelerated fractionation (LCAF) radiotherapy in early-stage nasopharyngeal carcinoma (NPC). MATERIALS AND METHODS: From December 1995 to November 2002, 158 patients with stages I-II NPC were admitted for radiotherapy alone. For the first two-thirds of the treatment, 2 daily fractions of 1.2 Gy were given to the primary lesion, 5 days per week to a total dose of 48 Gy/40 fractions, over a period of 4 weeks. From the 5th week, an accelerated hyperfractionation schedule was carried out. Two daily fractions of 1.5 Gy were given, to a total dose of 30 Gy/20 fractions over 2 weeks. Thus the total dose was 78 Gy in 60 fractions in 6 weeks. RESULTS: All patients completed the treatment. Acute mucositis: none in 3 patients, grade 1 in 32, grade 2 in 69, grade 3 in 51, and grade 4 in 3 patients. Five-year nasopharyngeal control and overall survival (OS) rate of T1 and T2 were 97.8%, 90.2% (p=0.380) and 88.6%, 81.4% (p=0.252), respectively. Five-year OS in N0 and N1 patients were 86.5% and 81.9% (p=0.033), respectively. Thirty-eight patients died, and the main cause of death was distant metastasis. Seventeen (11%) patients had radiation-induced cranial nerve palsy. CONCLUSION: With LCAF, treatment-related toxicities were acceptable. Five-year nasopharyngeal control and OS in T2 stage were improved. Main cause of death was distant metastasis. Patients with N1 had a relatively lower survival rate, which suggested that chemotherapy might be indicated for those patients.
OBJECTIVES: To follow up the efficacy and incidence of radiation-induced complications of late course accelerated fractionation (LCAF) radiotherapy in early-stage nasopharyngeal carcinoma (NPC). MATERIALS AND METHODS: From December 1995 to November 2002, 158 patients with stages I-II NPC were admitted for radiotherapy alone. For the first two-thirds of the treatment, 2 daily fractions of 1.2 Gy were given to the primary lesion, 5 days per week to a total dose of 48 Gy/40 fractions, over a period of 4 weeks. From the 5th week, an accelerated hyperfractionation schedule was carried out. Two daily fractions of 1.5 Gy were given, to a total dose of 30 Gy/20 fractions over 2 weeks. Thus the total dose was 78 Gy in 60 fractions in 6 weeks. RESULTS: All patients completed the treatment. Acute mucositis: none in 3 patients, grade 1 in 32, grade 2 in 69, grade 3 in 51, and grade 4 in 3 patients. Five-year nasopharyngeal control and overall survival (OS) rate of T1 and T2 were 97.8%, 90.2% (p=0.380) and 88.6%, 81.4% (p=0.252), respectively. Five-year OS in N0 and N1 patients were 86.5% and 81.9% (p=0.033), respectively. Thirty-eight patients died, and the main cause of death was distant metastasis. Seventeen (11%) patients had radiation-induced cranial nerve palsy. CONCLUSION: With LCAF, treatment-related toxicities were acceptable. Five-year nasopharyngeal control and OS in T2 stage were improved. Main cause of death was distant metastasis. Patients with N1 had a relatively lower survival rate, which suggested that chemotherapy might be indicated for those patients.
Authors: Stefan Janssen; Christoph Glanzmann; Bita Yousefi; Karl Loewenich; Gerhard Huber; Stephan Schmid; Gabriela Studer Journal: Mol Clin Oncol Date: 2015-05-04
Authors: Katherine A Hutcheson; Maggie Yuk; Rachel Hubbard; Gary B Gunn; C David Fuller; Stephen Y Lai; Heather Lin; Adam S Garden; David I Rosenthal; Ehab Y Hanna; Merrill S Kies; Jan S Lewin Journal: Head Neck Date: 2017-04-28 Impact factor: 3.147