Fang Wu1, Rensheng Wang2, Heming Lu3, Bo Wei4, Guosheng Feng3, Guisheng Li5, Meilian Liu6, Haolin Yan7, Jinxian Zhu8, Yong Zhang1, Kai Hu1. 1. Department of Radiation Oncology, First Affiliated Hospital of Guangxi Medical University, Nanning, People's Republic of China. 2. Department of Radiation Oncology, First Affiliated Hospital of Guangxi Medical University, Nanning, People's Republic of China. Electronic address: 13807806008@163.com. 3. Department of Radiation Oncology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, People's Republic of China. 4. Department of Epidemiology and Social Medicine, Guangxi Medical University, Nanning, People's Republic of China. 5. Department of Radiation Oncology, Liuzhou Worker Hospital, People's Republic of China. 6. Department of Radiation Oncology, Affiliated Hospital of Guilin Medical University, People's Republic of China. 7. Department of Radiation Oncology, First People's Hospital of Yulin City, People's Republic of China. 8. Department of Radiation Oncology, Wuzhou Red Cross Hospital, People's Republic of China.
Abstract
BACKGROUND AND PURPOSE: To evaluate long-term outcome in locoregionally advanced nasopharyngeal carcinoma (NPC) treated with intensity-modulated radiation therapy (IMRT) and concurrent chemotherapy. MATERIAL AND METHODS: Between January 2006 and August 2008, 249 patients with stage III-IVb NPC were treated by IMRT plus concurrent chemotherapy in this multicenter prospective study. RESULTS: With a mean follow-up of 54.1 months, the 5-year actuarial rates of overall survival (OS), local recurrence-free survival (LRFS), regional recurrence-free survival (RRFS), and distant metastasis-free survival (DMFS) were 78.4%, 86.8%, 88.4%, 78.0%, respectively. There were 29 local recurrences, 25 regional recurrences and 52 distant metastases, respectively. Distant metastasis is the main cause of treatment failure. N-stage was an independent prognostic factor for LRFS, RRFS, DMFS and OS. Acute toxicity ⩾grade III mainly consisted of mucositis (34.9%), neutropenia (11.2%), xerostomia (5.6%), and dermatitis (5.2%). The main documented late toxicity was xerostomia, and the severity of xerostomia decreased over time. At 24 months after treatment, 13.2% of patients had grade 2 xerostomia, and none had grade 3 or 4 xerostomia. CONCLUSIONS: IMRT with concurrent cisplatin chemotherapy resulted in encouraging rates of local and distant control and overall survival with acceptable rates of acute and limited rates of late toxicity in patients with locoregionally advanced NPC. Distant metastasis remained the main cause of failure. More effective systemic therapy should be explored for patients with advanced N-stage.
BACKGROUND AND PURPOSE: To evaluate long-term outcome in locoregionally advanced nasopharyngeal carcinoma (NPC) treated with intensity-modulated radiation therapy (IMRT) and concurrent chemotherapy. MATERIAL AND METHODS: Between January 2006 and August 2008, 249 patients with stage III-IVb NPC were treated by IMRT plus concurrent chemotherapy in this multicenter prospective study. RESULTS: With a mean follow-up of 54.1 months, the 5-year actuarial rates of overall survival (OS), local recurrence-free survival (LRFS), regional recurrence-free survival (RRFS), and distant metastasis-free survival (DMFS) were 78.4%, 86.8%, 88.4%, 78.0%, respectively. There were 29 local recurrences, 25 regional recurrences and 52 distant metastases, respectively. Distant metastasis is the main cause of treatment failure. N-stage was an independent prognostic factor for LRFS, RRFS, DMFS and OS. Acute toxicity ⩾grade III mainly consisted of mucositis (34.9%), neutropenia (11.2%), xerostomia (5.6%), and dermatitis (5.2%). The main documented late toxicity was xerostomia, and the severity of xerostomia decreased over time. At 24 months after treatment, 13.2% of patients had grade 2 xerostomia, and none had grade 3 or 4 xerostomia. CONCLUSIONS: IMRT with concurrent cisplatin chemotherapy resulted in encouraging rates of local and distant control and overall survival with acceptable rates of acute and limited rates of late toxicity in patients with locoregionally advanced NPC. Distant metastasis remained the main cause of failure. More effective systemic therapy should be explored for patients with advanced N-stage.
Authors: Luciana Lastrucci; Silvia Bertocci; Vittorio Bini; Simona Borghesi; Roberta De Majo; Andrea Rampini; Paola Pernici; Pietro Giovanni Gennari Journal: Radiol Med Date: 2017-01-09 Impact factor: 3.469