Shaojun Lin1, Jianji Pan2, Lu Han3, Qiaojuan Guo1, Cairong Hu3, Jingfeng Zong1, Xiuchun Zhang3, Jiade Jay Lu4. 1. Department of Radiation Oncology, Cancer Hospital of Fujian Medical University, Fuzhou, Fujian, China; Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fuzhou, Fujian, China. 2. Department of Radiation Oncology, Cancer Hospital of Fujian Medical University, Fuzhou, Fujian, China; Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fuzhou, Fujian, China. Electronic address: panjianji@126.com. 3. Department of Radiation Oncology, Cancer Hospital of Fujian Medical University, Fuzhou, Fujian, China. 4. Shanghai Proton and Heavy Ion Center, Shanghai, China; Department of Radiation Oncology, Fudan University, Shanghai Cancer Center, Shanghai, China. Electronic address: mdcljj@nus.edu.sg.
Abstract
BACKGROUND AND PURPOSE: To establish the minimally required margins in different directions measured from GTV in the definitive treatment of nasopharyngeal carcinoma (NPC) using IMRT based on the 5-year results. METHODS AND MATERIALS: Between November 2003 and May 2007, 414 patients with non-metastatic NPC were treated with IMRT according to our institutional protocol. Treatment outcomes at 5 years were analyzed. Distances from GTV-T to CTV2 (i.e., CTV 59.4 Gy) in 6 directions (anterior, posterior, superior, inferior, and bilateral) were measured and analyzed. RESULTS: The 5-year estimated overall survival (OS), disease free survival (DFS), local control (LC) were 80%, 77% and 95%, respectively. For the margins measured from GTV-T to CTV2, margins used with T4 disease were significantly and uniformly smaller than the whole group in all the 6 directions (P=0.000, 0.000, 0.000, 0.000 and 0.046, respectively). However, no increase of local recurrence was associated to this limited margins used. CONCLUSIONS: Our 5-years' experience showed a very high LC rate. The strategy we used for CTV delineation was safe and reliable. Determined CTV through GTV expansion to a minimally required margin, using GTV+margin (used in our T4 patients)+the whole nasopharyngeal mucosa, especially for the patients with early T disease, might be feasible. Crown
BACKGROUND AND PURPOSE: To establish the minimally required margins in different directions measured from GTV in the definitive treatment of nasopharyngeal carcinoma (NPC) using IMRT based on the 5-year results. METHODS AND MATERIALS: Between November 2003 and May 2007, 414 patients with non-metastatic NPC were treated with IMRT according to our institutional protocol. Treatment outcomes at 5 years were analyzed. Distances from GTV-T to CTV2 (i.e., CTV 59.4 Gy) in 6 directions (anterior, posterior, superior, inferior, and bilateral) were measured and analyzed. RESULTS: The 5-year estimated overall survival (OS), disease free survival (DFS), local control (LC) were 80%, 77% and 95%, respectively. For the margins measured from GTV-T to CTV2, margins used with T4 disease were significantly and uniformly smaller than the whole group in all the 6 directions (P=0.000, 0.000, 0.000, 0.000 and 0.046, respectively). However, no increase of local recurrence was associated to this limited margins used. CONCLUSIONS: Our 5-years' experience showed a very high LC rate. The strategy we used for CTV delineation was safe and reliable. Determined CTV through GTV expansion to a minimally required margin, using GTV+margin (used in our T4 patients)+the whole nasopharyngeal mucosa, especially for the patients with early T disease, might be feasible. Crown
Authors: Katelyn O Stepan; Angela L Mazul; S Andrew Skillington; Randal C Paniello; Jason T Rich; Jose P Zevallos; Ryan S Jackson; Patrik Pipkorn; Sean Massa; Sidharth V Puram Journal: Head Neck Date: 2021-02-23 Impact factor: 3.821