Sung Ho Moon1, Kwan Ho Cho2, Chang-Geol Lee3, Ki Chang Keum3, Yeon-Sil Kim4, Hong-Gyun Wu5, Jin Ho Kim5, Yong Chan Ahn6, Dongryul Oh6, Jong Hoon Lee7. 1. Proton Therapy Center, Research Institute and Hospital, National Cancer Center, 323 Ilsan-ro, 10408, Ilsandong-gu, Goyang-si Gyeonggi-do, Republic of Korea. 2. Proton Therapy Center, Research Institute and Hospital, National Cancer Center, 323 Ilsan-ro, 10408, Ilsandong-gu, Goyang-si Gyeonggi-do, Republic of Korea. kwancho@ncc.re.kr. 3. Department of Radiation Oncology, Yonsei University College of Medicine, 50-1 Yonsei-ro, 03722, Seodaemun-gu, Seoul, Republic of Korea. 4. Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, the Catholic University of Korea, 222 Banpo-daero, 06591, Seocho-gu, Seoul, Republic of Korea. 5. Department of Radiation Oncology, Seoul National University College of Medicine, 101 Daehak-ro, 03080, Jongno-gu, Seoul, Republic of Korea. 6. Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, 06351, Gangnam-gu, Seoul, Republic of Korea. 7. Department of Radiation Oncology, The Catholic University of Korea, College of Medicine, 93 Jungbu-daero, 16247, Paldal-gu, Suwon, Gyeonggi-do, Republic of Korea.
Abstract
OBJECTIVE: We compared treatment outcomes of two-dimensional radiotherapy (2D-RT), three-dimensional conformal radiotherapy (3D-CRT), and intensity-modulated radiotherapy (IMRT) in patients with nasopharyngeal carcinoma (NPC). PATIENTS AND METHODS: In total, 1237 patients with cT1-4N0-3M0 NPC were retrospectively analyzed. Of these, 350, 390, and 497 were treated with 2D-RT, 3D-CRT, and IMRT, respectively. RESULTS: 3D-CRT and IMRT showed better 5-year overall survival (OS) rates (73.6 and 76.7 %, respectively) than did 2D-RT (5-year OS of 59.7 %, all p < 0.001). In T3-4 subgroup, IMRT was associated with a significantly better 5-year OS than was 2D-RT (70.7 vs. 50.4 %, respectively; p ≤ 0.001) and 3D-CRT (70.7 vs. 57.8 %, respectively; p = 0.011); however, the difference between the 2D-RT and 3D-CRT groups did not reach statistical significance (p = 0.063). In multivariate analyses of all patients, IMRT was a predictive factor for OS when compared with 2D-RT or 3D-CRT, as was 3D-CRT when compared with 2D-RT. CONCLUSION: Our study showed that 3D-CRT and IMRT were associated with a better local progression-free survival and OS than was 2D-RT in NPC. IMRT was significantly superior in terms of OS for advanced primary tumors (T3-4).
OBJECTIVE: We compared treatment outcomes of two-dimensional radiotherapy (2D-RT), three-dimensional conformal radiotherapy (3D-CRT), and intensity-modulated radiotherapy (IMRT) in patients with nasopharyngeal carcinoma (NPC). PATIENTS AND METHODS: In total, 1237 patients with cT1-4N0-3M0 NPC were retrospectively analyzed. Of these, 350, 390, and 497 were treated with 2D-RT, 3D-CRT, and IMRT, respectively. RESULTS: 3D-CRT and IMRT showed better 5-year overall survival (OS) rates (73.6 and 76.7 %, respectively) than did 2D-RT (5-year OS of 59.7 %, all p < 0.001). In T3-4 subgroup, IMRT was associated with a significantly better 5-year OS than was 2D-RT (70.7 vs. 50.4 %, respectively; p ≤ 0.001) and 3D-CRT (70.7 vs. 57.8 %, respectively; p = 0.011); however, the difference between the 2D-RT and 3D-CRT groups did not reach statistical significance (p = 0.063). In multivariate analyses of all patients, IMRT was a predictive factor for OS when compared with 2D-RT or 3D-CRT, as was 3D-CRT when compared with 2D-RT. CONCLUSION: Our study showed that 3D-CRT and IMRT were associated with a better local progression-free survival and OS than was 2D-RT in NPC. IMRT was significantly superior in terms of OS for advanced primary tumors (T3-4).
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