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Conference Paper: Efficacy and toxicity of reirradiation using Intensity Modulated Radiotherapy for recurrent or second primary nasopharyngeal carcinoma

TitleEfficacy and toxicity of reirradiation using Intensity Modulated Radiotherapy for recurrent or second primary nasopharyngeal carcinoma
Authors
KeywordsMedical sciences
Radiology and nuclear medicine
Issue Date2012
PublisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/ijrobp
Citation
The 53rd Annual Meeting of the American Society of Therapeutic Radiology and Oncology (ASTRO 2011), Miami Beach, FL., 2-5 October 2011. In International Journal of Radiation: Oncology - Biology - Physics, 2011, v. 81 n. 2 suppl., p. S507 How to Cite?
AbstractPURPOSE/OBJECTIVE(S): Patients with recurrent or second primary nasopharyngeal carcinoma (NPC) have a poor prognosis due to limited therapeutic options. External beam reirradiation is often used, but it is difficult to retreat the target to high dose due to reduced therapeutic ratio. Intensity-modulated radiotherapy (IMRT) is a highly conformal technique that may improve treatment outcome when used for reirradiation of head and neck cancers. This study reported our experience in using IMRT-based salvage regimen for recurrent or second primary NPC. MATERIALS/METHODS: This was a retrospective study of patients treated by IMRT for recurrent or second primary NPC at Queen Mary Hospital and Hong Kong Sanatorium & Hospital. Only patients with loco-regional disease were included in the report. The primary endpoint was overall survival (OS), and secondary endpoints were loco-regional control (LRC) rate, local control (LC) rate and late toxicity. RESULTS: Fifty patients were treated using step-and-shoot IMRT (n:46) or helical tomotherapy (n:4) from December 2000 to March 2010. Thirty-nine patients (78%) also received platinum-based induction chemotherapy prior to reirradiation, 19 patients (38%) received cetuximab concurrently with reirradiation, and 10 patients (20%) received stereotactic radiosurgery boost after reirradiation. The median radiation dose was 56Gy. The median follow-up for censored subjects was 47 months. The 3-year actuarial OS and LRC rates were 47.4% and 43.4%, respectively. Patients treated for rT4 disease had a significantly worse tumor control than those treated for rT1 - 3 disease, the corresponding 3-year LC rates were 29.8% and 61.8% (p = 0.037). Approximately 48% of patients had late toxicity following treatment, and 12% had at least one grade 3 late toxicity. Two treatment-related deaths were observed, both due to severe hemorrhage secondary to carotid pseudoaneurysm. CONCLUSIONS: Aggressive IMRT-based salvage regimen was found to be feasible and resulted in relatively good tumor control and survival outcome in retreatment of NPC. Late toxicities were common, but severe toxicities appeared to be less common then other series describing reirradiation using non-IMRT approach. Copyright © 2011 Published by Elsevier Inc.
DescriptionThis journal suppl. entitled: Proceedings of the American Society for Radiation Oncology 53rd Annual Meeting
Persistent Identifierhttp://hdl.handle.net/10722/194790
ISSN
2015 Impact Factor: 4.495
2015 SCImago Journal Rankings: 2.274

 

DC FieldValueLanguage
dc.contributor.authorHo, Pen_US
dc.contributor.authorChua, DTTen_US
dc.contributor.authorWong, LSen_US
dc.contributor.authorLee, VHFen_US
dc.contributor.authorLeung, TWen_US
dc.date.accessioned2014-02-17T02:09:51Z-
dc.date.available2014-02-17T02:09:51Z-
dc.date.issued2012en_US
dc.identifier.citationThe 53rd Annual Meeting of the American Society of Therapeutic Radiology and Oncology (ASTRO 2011), Miami Beach, FL., 2-5 October 2011. In International Journal of Radiation: Oncology - Biology - Physics, 2011, v. 81 n. 2 suppl., p. S507en_US
dc.identifier.issn0360-3016-
dc.identifier.urihttp://hdl.handle.net/10722/194790-
dc.descriptionThis journal suppl. entitled: Proceedings of the American Society for Radiation Oncology 53rd Annual Meeting-
dc.description.abstractPURPOSE/OBJECTIVE(S): Patients with recurrent or second primary nasopharyngeal carcinoma (NPC) have a poor prognosis due to limited therapeutic options. External beam reirradiation is often used, but it is difficult to retreat the target to high dose due to reduced therapeutic ratio. Intensity-modulated radiotherapy (IMRT) is a highly conformal technique that may improve treatment outcome when used for reirradiation of head and neck cancers. This study reported our experience in using IMRT-based salvage regimen for recurrent or second primary NPC. MATERIALS/METHODS: This was a retrospective study of patients treated by IMRT for recurrent or second primary NPC at Queen Mary Hospital and Hong Kong Sanatorium & Hospital. Only patients with loco-regional disease were included in the report. The primary endpoint was overall survival (OS), and secondary endpoints were loco-regional control (LRC) rate, local control (LC) rate and late toxicity. RESULTS: Fifty patients were treated using step-and-shoot IMRT (n:46) or helical tomotherapy (n:4) from December 2000 to March 2010. Thirty-nine patients (78%) also received platinum-based induction chemotherapy prior to reirradiation, 19 patients (38%) received cetuximab concurrently with reirradiation, and 10 patients (20%) received stereotactic radiosurgery boost after reirradiation. The median radiation dose was 56Gy. The median follow-up for censored subjects was 47 months. The 3-year actuarial OS and LRC rates were 47.4% and 43.4%, respectively. Patients treated for rT4 disease had a significantly worse tumor control than those treated for rT1 - 3 disease, the corresponding 3-year LC rates were 29.8% and 61.8% (p = 0.037). Approximately 48% of patients had late toxicity following treatment, and 12% had at least one grade 3 late toxicity. Two treatment-related deaths were observed, both due to severe hemorrhage secondary to carotid pseudoaneurysm. CONCLUSIONS: Aggressive IMRT-based salvage regimen was found to be feasible and resulted in relatively good tumor control and survival outcome in retreatment of NPC. Late toxicities were common, but severe toxicities appeared to be less common then other series describing reirradiation using non-IMRT approach. Copyright © 2011 Published by Elsevier Inc.en_US
dc.languageengen_US
dc.publisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/ijrobpen_US
dc.relation.ispartofInternational Journal of Radiation: Oncology - Biology - Physicsen_US
dc.subjectMedical sciences-
dc.subjectRadiology and nuclear medicine-
dc.titleEfficacy and toxicity of reirradiation using Intensity Modulated Radiotherapy for recurrent or second primary nasopharyngeal carcinomaen_US
dc.typeConference_Paperen_US
dc.identifier.emailChua, DTT: dttchua@hkucc.hku.hken_US
dc.identifier.emailLee, VHF: vhflee@hku.hken_US
dc.identifier.emailLeung, TW: ltw920@hkucc.hku.hken_US
dc.identifier.authorityChua, DTT=rp00415en_US
dc.identifier.authorityLee, VHF=rp00264en_US
dc.identifier.doi10.1016/j.ijrobp.2011.06.1036-
dc.identifier.hkuros227970en_US
dc.identifier.volume81en_US
dc.identifier.issue2 suppl.en_US
dc.identifier.spageS507en_US
dc.identifier.epageS507en_US
dc.publisher.placeUnited Statesen_US

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