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Article: Dose-response relationship of nasopharyngeal carcinoma above conventional tumoricidal level: A study by the Hong Kong nasopharyngeal carcinoma study group (HKNPCSG)

TitleDose-response relationship of nasopharyngeal carcinoma above conventional tumoricidal level: A study by the Hong Kong nasopharyngeal carcinoma study group (HKNPCSG)
Authors
KeywordsDose-response
Local control
Nasopharyngeal carcinoma
Issue Date2006
PublisherElsevier Ireland Ltd. The Journal's web site is located at http://www.elsevier.com/locate/radonc
Citation
Radiotherapy And Oncology, 2006, v. 79 n. 1, p. 27-33 How to Cite?
AbstractBackground and purpose: To define the dose-response relationship of nasopharyngeal carcinoma (NPC) above the conventional tumoricidal dose level of 66 Gy when the basic radiotherapy (RT) course was given by the 2D Ho's technique. Patients and methods: Data from all five regional cancer centers in Hong Kong were pooled for this retrospective study. All patients (n=2426) were treated with curative-intent RT with or without chemotherapy between 1996 and 2000 with the basic RT course using the Ho's technique. The primary endpoint was local control. The prognostic significance of dose-escalation ('boost') after 66 Gy, T-stage, N-stage, use of chemotherapy, sex and age (≤40 years vs >40 years) was studied. Both univariate and multivariate analyses were performed. Results: On multivariate analysis, T-stage (P< 0.01; hazard ratio [HR], 1.58) and optimal boost (P=0.01; HR, 0.34) were the only significant factors affecting local failure for the whole study population, and for the population of patients treated by radiotherapy alone, but not for patients who also received chemotherapy. The following were independent determinants of local failure for patient groups with different T-stages treated by radiotherapy alone: use of a boost in T1/T2a disease (P=0.01; HR, 0.33); use of a boost (P<0.01; HR, 0.60) and age (P=0.01; HR, 1.02) in T3/T4 tumors. Among patients with T2b tumors treated by radiotherapy alone and given a boost, the use of a 20 Gy-boost gave a lower local failure rate than a 10 Gy-boost. There was no apparent excess mortality attributed to RT complications. Conclusions: Within the context of a multi-center retrospective study, dose-escalation above 66 Gy significantly improved local control for T1/T2a and T3/4 tumors when the primary RT course was based on the 2D Ho's technique without additional chemotherapy. 'Boosting' in NPC warrants further investigation. Caution should be taken when boosting is considered because of possible increase in radiation toxicity. © 2006 Elsevier Ireland Ltd. All rights reserved.
Persistent Identifierhttp://hdl.handle.net/10722/150803
ISSN
2015 Impact Factor: 4.817
2015 SCImago Journal Rankings: 2.654
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorTeo, PMLen_HK
dc.contributor.authorLeung, SFen_HK
dc.contributor.authorTung, SYen_HK
dc.contributor.authorZee, Ben_HK
dc.contributor.authorSham, JSTen_HK
dc.contributor.authorLee, AWMen_HK
dc.contributor.authorLau, WHen_HK
dc.contributor.authorKwan, WHen_HK
dc.contributor.authorLeung, TWen_HK
dc.contributor.authorChua, Den_HK
dc.contributor.authorSze, WMen_HK
dc.contributor.authorAu, JSKen_HK
dc.contributor.authorYu, KHen_HK
dc.contributor.authorO, SKen_HK
dc.contributor.authorKwong, Den_HK
dc.contributor.authorYau, TKen_HK
dc.contributor.authorLaw, SCKen_HK
dc.contributor.authorSze, WKen_HK
dc.contributor.authorAu, Gen_HK
dc.contributor.authorChan, ATCen_HK
dc.date.accessioned2012-06-26T06:10:44Z-
dc.date.available2012-06-26T06:10:44Z-
dc.date.issued2006en_HK
dc.identifier.citationRadiotherapy And Oncology, 2006, v. 79 n. 1, p. 27-33en_HK
dc.identifier.issn0167-8140en_HK
dc.identifier.urihttp://hdl.handle.net/10722/150803-
dc.description.abstractBackground and purpose: To define the dose-response relationship of nasopharyngeal carcinoma (NPC) above the conventional tumoricidal dose level of 66 Gy when the basic radiotherapy (RT) course was given by the 2D Ho's technique. Patients and methods: Data from all five regional cancer centers in Hong Kong were pooled for this retrospective study. All patients (n=2426) were treated with curative-intent RT with or without chemotherapy between 1996 and 2000 with the basic RT course using the Ho's technique. The primary endpoint was local control. The prognostic significance of dose-escalation ('boost') after 66 Gy, T-stage, N-stage, use of chemotherapy, sex and age (≤40 years vs >40 years) was studied. Both univariate and multivariate analyses were performed. Results: On multivariate analysis, T-stage (P< 0.01; hazard ratio [HR], 1.58) and optimal boost (P=0.01; HR, 0.34) were the only significant factors affecting local failure for the whole study population, and for the population of patients treated by radiotherapy alone, but not for patients who also received chemotherapy. The following were independent determinants of local failure for patient groups with different T-stages treated by radiotherapy alone: use of a boost in T1/T2a disease (P=0.01; HR, 0.33); use of a boost (P<0.01; HR, 0.60) and age (P=0.01; HR, 1.02) in T3/T4 tumors. Among patients with T2b tumors treated by radiotherapy alone and given a boost, the use of a 20 Gy-boost gave a lower local failure rate than a 10 Gy-boost. There was no apparent excess mortality attributed to RT complications. Conclusions: Within the context of a multi-center retrospective study, dose-escalation above 66 Gy significantly improved local control for T1/T2a and T3/4 tumors when the primary RT course was based on the 2D Ho's technique without additional chemotherapy. 'Boosting' in NPC warrants further investigation. Caution should be taken when boosting is considered because of possible increase in radiation toxicity. © 2006 Elsevier Ireland Ltd. All rights reserved.en_HK
dc.languageengen_US
dc.publisherElsevier Ireland Ltd. The Journal's web site is located at http://www.elsevier.com/locate/radoncen_HK
dc.relation.ispartofRadiotherapy and Oncologyen_HK
dc.subjectDose-responseen_HK
dc.subjectLocal controlen_HK
dc.subjectNasopharyngeal carcinomaen_HK
dc.subject.meshAdulten_US
dc.subject.meshAnalysis Of Varianceen_US
dc.subject.meshAntineoplastic Combined Chemotherapy Protocols - Therapeutic Useen_US
dc.subject.meshCarcinoma - Drug Therapy - Mortality - Pathology - Radiotherapyen_US
dc.subject.meshChemotherapy, Adjuvanten_US
dc.subject.meshDose-Response Relationship, Radiationen_US
dc.subject.meshFemaleen_US
dc.subject.meshFollow-Up Studiesen_US
dc.subject.meshHong Kongen_US
dc.subject.meshHumansen_US
dc.subject.meshMedical Recordsen_US
dc.subject.meshNasopharyngeal Neoplasms - Drug Therapy - Mortality - Pathology - Radiotherapyen_US
dc.subject.meshNeoplasm Stagingen_US
dc.subject.meshRadiotherapy, Adjuvanten_US
dc.subject.meshRetrospective Studiesen_US
dc.subject.meshSurvival Analysisen_US
dc.subject.meshTreatment Outcomeen_US
dc.titleDose-response relationship of nasopharyngeal carcinoma above conventional tumoricidal level: A study by the Hong Kong nasopharyngeal carcinoma study group (HKNPCSG)en_HK
dc.typeArticleen_HK
dc.identifier.emailChua, D: dttchua@hkucc.hku.hken_HK
dc.identifier.emailKwong, D: dlwkwong@hku.hken_HK
dc.identifier.authorityChua, D=rp00415en_HK
dc.identifier.authorityKwong, D=rp00414en_HK
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1016/j.radonc.2006.03.012en_HK
dc.identifier.pmid16626829-
dc.identifier.scopuseid_2-s2.0-33747874526en_HK
dc.identifier.hkuros266111-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-33747874526&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume79en_HK
dc.identifier.issue1en_HK
dc.identifier.spage27en_HK
dc.identifier.epage33en_HK
dc.identifier.isiWOS:000237911500004-
dc.publisher.placeIrelanden_HK
dc.identifier.scopusauthoridTeo, PML=7006685066en_HK
dc.identifier.scopusauthoridLeung, SF=7202044876en_HK
dc.identifier.scopusauthoridTung, SY=7102858954en_HK
dc.identifier.scopusauthoridZee, B=7006378172en_HK
dc.identifier.scopusauthoridSham, JST=24472255400en_HK
dc.identifier.scopusauthoridLee, AWM=17035384900en_HK
dc.identifier.scopusauthoridLau, WH=7402933278en_HK
dc.identifier.scopusauthoridKwan, WH=7006610872en_HK
dc.identifier.scopusauthoridLeung, TW=7202110934en_HK
dc.identifier.scopusauthoridChua, D=7006773480en_HK
dc.identifier.scopusauthoridSze, WM=7003795941en_HK
dc.identifier.scopusauthoridAu, JSK=7101921203en_HK
dc.identifier.scopusauthoridYu, KH=7403385647en_HK
dc.identifier.scopusauthoridO, SK=6603967563en_HK
dc.identifier.scopusauthoridKwong, D=15744231600en_HK
dc.identifier.scopusauthoridYau, TK=7006540678en_HK
dc.identifier.scopusauthoridLaw, SCK=7202241299en_HK
dc.identifier.scopusauthoridSze, WK=7003795949en_HK
dc.identifier.scopusauthoridAu, G=7003748615en_HK
dc.identifier.scopusauthoridChan, ATC=13404833700en_HK

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