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Article: Retrospective analysis on treating nasopharyngeal carcinoma with accelerated fractionation (6 fractions per week) in comparison with conventional fractionation (5 fractions per week): Report on 3-year tumor control and normal tissue toxicity

TitleRetrospective analysis on treating nasopharyngeal carcinoma with accelerated fractionation (6 fractions per week) in comparison with conventional fractionation (5 fractions per week): Report on 3-year tumor control and normal tissue toxicity
Authors
KeywordsNasopharyngeal neoplasm
Conventional fractionation
Accelerated fractionation
Issue Date2001
Citation
Radiotherapy and Oncology, 2001, v. 58, n. 2, p. 121-130 How to Cite?
AbstractBackground and purpose: To assess the therapeutic gain achieved by accelerated fractionation for non-keratinizing/undifferentiated nasopharyngeal carcinoma (NPC). Materials and methods: During January 1994 to October 1997, 325 patients were treated to a total dose of 66 Gy in 33-37 fractions: 167 (irradiated before mid-January 1996) with 5 daily fractions (CF) and subsequent 158 with 6 daily fractions (AF) per week. Their median treatment times were 46 and 39 days, respectively. Additional boost to parapharyngeal extension had been given to 181 and Cisplatin-based chemotherapy to 57 patients (24 concurrent with radiotherapy). Results: The AF group had significantly higher progression-free rate than the CF Group (74 vs. 63% at 3 years, P = 0.02 by the log-rank test). However, the difference in disease-specific survival (86 vs. 80%, P = 0.39) and overall survival (81 vs. 78%, P = 0.9) did not reach statistical significance. Strongly significant improvement in local failure-free rate was achieved for patients with T3-4 tumors (87 vs. 62%, P < 0.01). Multivariate analyses showed that fractionation was an independent significant factor for overall progression: hazard ratio = 0.63, 95% confidence interval: 0.41-0.98, P = 0.04. Among the 268 patients treated with radiotherapy alone, those treated by AF had significantly higher incidence of acute reaction grade ≥3 (72 vs. 13%, P < 0.01). However, all patients completed the scheduled dose without excessive prolongation, and no significant increase in late complications was observed (20 vs. 15% at 3 years, P = 0.19). Conclusions: The current analyses suggested that acceleration to 6 daily fractions per week could significantly improve the progression-free rate for NPC without excessive late toxicity. Improvement in local control was confined to T3-4 tumors. © 2001 Elsevier Science Ireland Ltd.
Persistent Identifierhttp://hdl.handle.net/10722/213882
ISSN
2015 Impact Factor: 4.817
2015 SCImago Journal Rankings: 2.654

 

DC FieldValueLanguage
dc.contributor.authorLee, Anne W M-
dc.contributor.authorSze, Wai Man-
dc.contributor.authorYau, Tsz Kok-
dc.contributor.authorYeung, Rebecca M W-
dc.contributor.authorChappell, Rick-
dc.contributor.authorFowler, John F.-
dc.date.accessioned2015-08-19T13:41:04Z-
dc.date.available2015-08-19T13:41:04Z-
dc.date.issued2001-
dc.identifier.citationRadiotherapy and Oncology, 2001, v. 58, n. 2, p. 121-130-
dc.identifier.issn0167-8140-
dc.identifier.urihttp://hdl.handle.net/10722/213882-
dc.description.abstractBackground and purpose: To assess the therapeutic gain achieved by accelerated fractionation for non-keratinizing/undifferentiated nasopharyngeal carcinoma (NPC). Materials and methods: During January 1994 to October 1997, 325 patients were treated to a total dose of 66 Gy in 33-37 fractions: 167 (irradiated before mid-January 1996) with 5 daily fractions (CF) and subsequent 158 with 6 daily fractions (AF) per week. Their median treatment times were 46 and 39 days, respectively. Additional boost to parapharyngeal extension had been given to 181 and Cisplatin-based chemotherapy to 57 patients (24 concurrent with radiotherapy). Results: The AF group had significantly higher progression-free rate than the CF Group (74 vs. 63% at 3 years, P = 0.02 by the log-rank test). However, the difference in disease-specific survival (86 vs. 80%, P = 0.39) and overall survival (81 vs. 78%, P = 0.9) did not reach statistical significance. Strongly significant improvement in local failure-free rate was achieved for patients with T3-4 tumors (87 vs. 62%, P < 0.01). Multivariate analyses showed that fractionation was an independent significant factor for overall progression: hazard ratio = 0.63, 95% confidence interval: 0.41-0.98, P = 0.04. Among the 268 patients treated with radiotherapy alone, those treated by AF had significantly higher incidence of acute reaction grade ≥3 (72 vs. 13%, P < 0.01). However, all patients completed the scheduled dose without excessive prolongation, and no significant increase in late complications was observed (20 vs. 15% at 3 years, P = 0.19). Conclusions: The current analyses suggested that acceleration to 6 daily fractions per week could significantly improve the progression-free rate for NPC without excessive late toxicity. Improvement in local control was confined to T3-4 tumors. © 2001 Elsevier Science Ireland Ltd.-
dc.languageeng-
dc.relation.ispartofRadiotherapy and Oncology-
dc.subjectNasopharyngeal neoplasm-
dc.subjectConventional fractionation-
dc.subjectAccelerated fractionation-
dc.titleRetrospective analysis on treating nasopharyngeal carcinoma with accelerated fractionation (6 fractions per week) in comparison with conventional fractionation (5 fractions per week): Report on 3-year tumor control and normal tissue toxicity-
dc.typeArticle-
dc.description.natureLink_to_subscribed_fulltext-
dc.identifier.doi10.1016/S0167-8140(00)00312-1-
dc.identifier.pmid11166862-
dc.identifier.scopuseid_2-s2.0-0035252323-
dc.identifier.hkuros266065-
dc.identifier.volume58-
dc.identifier.issue2-
dc.identifier.spage121-
dc.identifier.epage130-

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