S Tonoli1, D Alterio2, O Caspiani3, A Bacigalupo4, F Bunkheila5, M Cianciulli6, A Merlotti7, A Podhradska8, M Rampino9, D Cante, L Bruschieri10, R Gatta11, S M Magrini11,12. 1. Istituto del Radio, Brescia University, A.O. Spedali Civili di Brescia, Piazzale Spedali Civili, 1, 25123, Brescia, Italy. sandro.tonoli@asst-spedalicivili.it. 2. Milan-European Institute of Oncology, Milan, Italy. 3. Roma-Isola Tiberina Hospital, Rome, Italy. 4. IRCCS A.O.U. San Martino IST Genoa, Genoa, Italy. 5. Bologna-S.Orsola Hospital, Bologna, Italy. 6. Roma-S.Camillo Hospital, Rome, Italy. 7. Busto Arsizio Hospital, Busto Arsizio, Italy. 8. Milan University - Monza S. Gerardo Hospital, Milan, Italy. 9. Turin University, Turin, Italy. 10. Treviglio Hospital, Treviglio, Italy. 11. Istituto del Radio, Brescia University, A.O. Spedali Civili di Brescia, Piazzale Spedali Civili, 1, 25123, Brescia, Italy. 12. Prato Hospital, Prato, Italy.
Abstract
PURPOSE: To evaluate the outcomes with respect to long-term survival and toxicity in patients with nasopharyngeal carcinoma (NPC) treated in a European country with low incidence. MATERIALS AND METHODS: A prospective observational study carried out by the AIRO Head and Neck group in 12 Italian institutions included 136 consecutive patients treated with radiotherapy (RT) ± chemotherapy (CHT) for NPC (without distant metastasis) between January 1, 2008 and December 31, 2010. RESULTS: The disease-specific survival (DSS), overall survival (OS), and disease-free survival (DFS) at 5 years were 92 (±2), 91 (±3), and 69 % (±5 %), respectively. Distant failure was the most frequent modality of relapse. The local, regional, and locoregional control at 5 years were 89 (±3), 93 (±3), and 84 % (±4 %), respectively. The incidence of acute and late toxicity and the correlations with different clinical/technical variables were analyzed. Neoadjuvant CHT prolongs radiotherapy overall treatment time (OTT) and decreases treatment adherence during concomitant chemoradiotherapy. An adequate minimum dose coverage to PTV(T) is a predictive variable well related to outcome. CONCLUSION: Our data do not substantially differ in terms of survival and toxicity outcomes from those reported in larger series of patients treated in countries with higher incidences of NPC. The T stage (TNM 2002 UICC classification) is predictive of DSS and OS. The GTV volume (T ± N) and an adequate minimum PTV(T) coverage dose (D95 %) were also identified as potential predictive variables. Sophisticated technologies of dose delivery (IMRT) with image-guided radiotherapy could help to obtain better minimum PTV(T) coverage dose with increased DFS; distant metastasis after treatment still remains an unresolved issue.
PURPOSE: To evaluate the outcomes with respect to long-term survival and toxicity in patients with nasopharyngeal carcinoma (NPC) treated in a European country with low incidence. MATERIALS AND METHODS: A prospective observational study carried out by the AIRO Head and Neck group in 12 Italian institutions included 136 consecutive patients treated with radiotherapy (RT) ± chemotherapy (CHT) for NPC (without distant metastasis) between January 1, 2008 and December 31, 2010. RESULTS: The disease-specific survival (DSS), overall survival (OS), and disease-free survival (DFS) at 5 years were 92 (±2), 91 (±3), and 69 % (±5 %), respectively. Distant failure was the most frequent modality of relapse. The local, regional, and locoregional control at 5 years were 89 (±3), 93 (±3), and 84 % (±4 %), respectively. The incidence of acute and late toxicity and the correlations with different clinical/technical variables were analyzed. Neoadjuvant CHT prolongs radiotherapy overall treatment time (OTT) and decreases treatment adherence during concomitant chemoradiotherapy. An adequate minimum dose coverage to PTV(T) is a predictive variable well related to outcome. CONCLUSION: Our data do not substantially differ in terms of survival and toxicity outcomes from those reported in larger series of patients treated in countries with higher incidences of NPC. The T stage (TNM 2002 UICC classification) is predictive of DSS and OS. The GTV volume (T ± N) and an adequate minimum PTV(T) coverage dose (D95 %) were also identified as potential predictive variables. Sophisticated technologies of dose delivery (IMRT) with image-guided radiotherapy could help to obtain better minimum PTV(T) coverage dose with increased DFS; distant metastasis after treatment still remains an unresolved issue.
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Authors: S M Magrini; S Tonoli; L Costa; N Pasinetti; F Paiar; L Livi; G Simontacchi; I Meattini; L Pegurri; P Borghetti; P Frata; P Ponticelli; M Buglione; G Biti Journal: Radiol Med Date: 2011-11-17 Impact factor: 3.469
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Authors: S Tonoli; S M Magrini; L Costa; F Paiar; G Simontacchi; V Scotti; N Pasinetti; R Barca; D Barbieri; A De Stefani; E Cellai; M Buglione; G Biti Journal: Radiol Med Date: 2011-11-17 Impact factor: 3.469
Authors: Francesco Perri; Giuseppina Della Vittoria Scarpati; Carlo Buonerba; Giuseppe Di Lorenzo; Francesco Longo; Paolo Muto; Concetta Schiavone; Fabio Sandomenico; Francesco Caponigro Journal: World J Clin Oncol Date: 2013-05-10