BACKGROUND: Radiation with or without chemotherapy is the main treatment of nasopharyngeal carcinomas (NPC). Local recurrence is difficult to manage. Local control is dose-dependent. AIM: To analyze the effect of an endocavitary brachytherapy boost after external beam radiation (EBRT) to decrease local recurrence. MATERIAL AND METHODS: Thirty patients with T0-T2 NPC were treated: 70% T1, 20% T2 and 10% T0; 33.3% N0, 20% N1, 43.3% N2 and 3.3% N3; 90% were undifferentiated carcinoma. All they received a 192-Ir high dose rate brachytherapy (HDR-BT) boost after 60 Gy of EBRT. The Rotterdam applicator was used in most cases, 3-4 fractions of 3.75-3 Gy in two days. RESULTS: With median follow-up (FU) of 63 months, a single parapharyngeal failure resulted in local control of 100% at 3 years and 95% at 5 years. Local control for T0-1 was 100% and for T2 67% at five years (p = 0.02). Regional-free recurrence survival was 92% at 5 years. Metastasis-free survival was 84% at 5 years. All cases of metastasis had histopathology of undifferentiated. The overall and cause-specific survival was 96% and 86% at 3 and 5 years. No late complications related to brachytherapy were described. CONCLUSION: A HDR-BT boost is useful to decrease the incidence of local recurrence of NPC to 5%. With a fractionated schedule of 3-4 fractions in two days, Rotterdam applicator and 3-D planning, no late complications are described. Therefore we recommend to use brachytherapy boost in all early NPC.
BACKGROUND: Radiation with or without chemotherapy is the main treatment of nasopharyngeal carcinomas (NPC). Local recurrence is difficult to manage. Local control is dose-dependent. AIM: To analyze the effect of an endocavitary brachytherapy boost after external beam radiation (EBRT) to decrease local recurrence. MATERIAL AND METHODS: Thirty patients with T0-T2 NPC were treated: 70% T1, 20% T2 and 10% T0; 33.3% N0, 20% N1, 43.3% N2 and 3.3% N3; 90% were undifferentiated carcinoma. All they received a 192-Ir high dose rate brachytherapy (HDR-BT) boost after 60 Gy of EBRT. The Rotterdam applicator was used in most cases, 3-4 fractions of 3.75-3 Gy in two days. RESULTS: With median follow-up (FU) of 63 months, a single parapharyngeal failure resulted in local control of 100% at 3 years and 95% at 5 years. Local control for T0-1 was 100% and for T2 67% at five years (p = 0.02). Regional-free recurrence survival was 92% at 5 years. Metastasis-free survival was 84% at 5 years. All cases of metastasis had histopathology of undifferentiated. The overall and cause-specific survival was 96% and 86% at 3 and 5 years. No late complications related to brachytherapy were described. CONCLUSION: A HDR-BT boost is useful to decrease the incidence of local recurrence of NPC to 5%. With a fractionated schedule of 3-4 fractions in two days, Rotterdam applicator and 3-D planning, no late complications are described. Therefore we recommend to use brachytherapy boost in all early NPC.
Authors: György Kovács; Rafael Martinez-Monge; Ashwini Budrukkar; Jose Luis Guinot; Bengt Johansson; Vratislav Strnad; Janusz Skowronek; Angeles Rovirosa; Frank-André Siebert Journal: Radiother Oncol Date: 2016-11-23 Impact factor: 6.280
Authors: Anuradha Thiagarajan; Kong Lin; Chua Eu Tiong; Luke Kim Siang Tan; Thomas Kwok Seng Loh; Boon Cher Goh; Jiade J Lu Journal: Laryngoscope Date: 2006-06 Impact factor: 3.325
Authors: Kwok Hung Yu; Sing Fai Leung; Stewart Yuk Tung; Benny Zee; Daniel T T Chua; Wai Man Sze; Stephen C K Law; Michael K M Kam; To Wai Leung; Jonathan S T Sham; Anne W M Lee; Joseph S K Au; Edwin P Hui; Wing Kin Sze; Ashley C K Cheng; T K Yau; Roger K C Ngan; Frank C S Wong; Gordon K H Au; Anthony T C Chan Journal: Head Neck Date: 2005-05 Impact factor: 3.147
Authors: Quynh-Thu Le; David Tate; Albert Koong; Iris C Gibbs; Steven D Chang; John R Adler; Harlan A Pinto; David J Terris; Willard E Fee; Don R Goffinet Journal: Int J Radiat Oncol Biol Phys Date: 2003-07-15 Impact factor: 7.038
Authors: Peter C Levendag; Fatma Keskin-Cambay; Connie de Pan; Marjolein Idzes; Maarten A Wildeman; Inge Noever; Inger-Karine Kolkman-Deurloo; Abrahim Al-Mamgani; M El-Gantiry; Eduardo Rosenblatt; David N Teguh Journal: Brachytherapy Date: 2012-11-04 Impact factor: 2.362