A Beddok1, L Feuvret2, G Noël3, S Bolle4, M Deberne5, H Mammar6, A Chaze7, C Le Tourneau8, F Goudjil6, S Zefkili9, P Herman10, R Dendale11, V Calugaru11. 1. Centre de protonthérapie, institut Curie, campus universitaire, 15, rue Georges-Clémenceau, bâtiment 101, 91400 Orsay, France. Electronic address: a.beddok@gmail.com. 2. Centre de protonthérapie, institut Curie, campus universitaire, 15, rue Georges-Clémenceau, bâtiment 101, 91400 Orsay, France; Département de radiothérapie. CHU Pitié-Salpêtri`re, 47-83 boulevard de l'hôpital, 75013 Paris, France. 3. Département de radiothérapie, centre Paul-Strauss, 3, rue de la Porte-de-l'Hôpital 67065 Strasbourg, France. 4. Département de radiothérapie, institut Gustave-Roussy, 114, rue édouard-Vaillant, 94800 Villejuif, France. 5. Département de radiothérapie, hôpital Lyon Sud, 165, chemin du Grand-Revoyet, 69310 Pierre-Bénite, France. 6. Centre de protonthérapie, institut Curie, campus universitaire, 15, rue Georges-Clémenceau, bâtiment 101, 91400 Orsay, France. 7. Statisticien, chercheur indépendant, 75012 Paris, France. 8. Département d'oncologie médicale, institut Curie, 25, rue d'Ulm, 75005 Paris, France. 9. Département de radiothérapie, institut Curie, 25, rue d'Ulm, 75005 Paris, France. 10. Département d'Oto-Rhino-Laryngologie, CHU Lariboisi`re, 2, rue Ambroise-Paré, 75475 Paris, France. 11. Centre de protonthérapie, institut Curie, campus universitaire, 15, rue Georges-Clémenceau, bâtiment 101, 91400 Orsay, France; Département de radiothérapie, institut Curie, 25, rue d'Ulm, 75005 Paris, France.
Abstract
PURPOSE: The aim of this study was to assess the treatment outcome and toxicity for patients with locally advanced nasopharyngeal carcinoma treated with a complementary dose with proton. PATIENTS AND METHODS: Between November 1999 and September 2016, 17 patients have been treated for a stage III-IVa nasopharyngeal carcinoma in the proton therapy centre of Curie Institute. Bilateral lymph node in the neck (I-V levels) received from 40 to 54Gy with photon beam. The primary tumor volume including microscopically extensions received a complementary dose with proton in order to reach the dose of 70 to 78Gy. All the patients received a concomitant chemotherapy. The end-points of the study were loco-regional control, survival, and treatment-related toxicity. RESULTS: Patients characteristics were: median age 49, 71 % male, 88% stage IVa, with a majority (82%) of T4N0M0. The median follow-up was 99 months. The 2-, 5- and 10-year actuarial locoregional free survival and overall survival were 94% and 88%, 86% and 74%, and 86% and 66%, respectively. The grade≥3 late adverse events were sphenoid bone radionecrosis (5.9%) and hearing loss (23.5%). CONCLUSION: This study showed that a complementary dose with proton seems to be a good option for the treatment of locally advanced nasopharyngeal carcinoma, particularly for T4N0M0.
PURPOSE: The aim of this study was to assess the treatment outcome and toxicity for patients with locally advanced nasopharyngeal carcinoma treated with a complementary dose with proton. PATIENTS AND METHODS: Between November 1999 and September 2016, 17 patients have been treated for a stage III-IVa nasopharyngeal carcinoma in the proton therapy centre of Curie Institute. Bilateral lymph node in the neck (I-V levels) received from 40 to 54Gy with photon beam. The primary tumor volume including microscopically extensions received a complementary dose with proton in order to reach the dose of 70 to 78Gy. All the patients received a concomitant chemotherapy. The end-points of the study were loco-regional control, survival, and treatment-related toxicity. RESULTS:Patients characteristics were: median age 49, 71 % male, 88% stage IVa, with a majority (82%) of T4N0M0. The median follow-up was 99 months. The 2-, 5- and 10-year actuarial locoregional free survival and overall survival were 94% and 88%, 86% and 74%, and 86% and 66%, respectively. The grade≥3 late adverse events were sphenoid bone radionecrosis (5.9%) and hearing loss (23.5%). CONCLUSION: This study showed that a complementary dose with proton seems to be a good option for the treatment of locally advanced nasopharyngeal carcinoma, particularly for T4N0M0.
Keywords:
Cancer de la tête et du cou; Cancers du nasopharynx; Chemoradiotherapy; Head and neck neoplasms; Nasopharyngeal neoplasms; Proton therapy; Protonthérapie; Radio-chimiothérapie