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- Publisher Website: 10.1016/j.ijrobp.2008.05.023
- Scopus: eid_2-s2.0-61349183760
- PMID: 18723296
- WOS: WOS:000264257400025
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Article: Major Late Toxicities After Conformal Radiotherapy for Nasopharyngeal Carcinoma-Patient- and Treatment-Related Risk Factors
Title | Major Late Toxicities After Conformal Radiotherapy for Nasopharyngeal Carcinoma-Patient- and Treatment-Related Risk Factors |
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Authors | |
Keywords | Concurrent chemotherapy Late toxicity Nasopharyngeal carcinoma Radiation boost |
Issue Date | 2009 |
Citation | International Journal of Radiation Oncology - Biology - Physics, 2009, v. 73, n. 4, p. 1121-1128 How to Cite? |
Abstract | Purpose: To retrospectively analyze the factors affecting late toxicity for nasopharyngeal carcinoma. Methods and Materials: Between 1998 and 2003, 422 patients were treated with a conformal technique with 2-Gy daily fractions to a total dose of 70 Gy. Conventional fractionation (5 fractions weekly) was used in 232 patients and accelerated fractionation (6 fractions weekly) in 190 patients. One hundred seventy-one patients were treated with the basic radiotherapy course alone (Group 1), 55 patients had an additional boost of 5 Gy in 2 fractions (Group 2), and 196 patients underwent concurrent cisplatin-based chemotherapy (Group 3). Results: The 5-year overall toxicity rate was significantly greater in Group 3 than in Group 1 (37% vs. 27%, p = 0.009). Although the overall rate in Group 2 was not elevated (28% vs. 27%, p = 0.697), a significant increase in temporal lobe necrosis was observed (4.8% vs. 0%, p = 0.015). Multivariate analyses showed that age and concurrent chemotherapy were significant factors. The hazard ratio of overall toxicity attributed to chemotherapy was 1.99 (95% confidence interval, 1.32-2.99, p = 0.001). The mean radiation dose to the cochlea was another significant factor affecting deafness, with a hazard ratio of 1.03 (95% confidence interval, 1.01-1.05, p = 0.005) per 1-Gy increase. The cochlea that received >50 Gy had a significantly greater deaf rate (Group 1, 18% vs. 7%; and Group 3, 22% vs. 14%). Conclusion: The therapeutic margin for nasopharyngeal carcinoma is extremely narrow, and a significant increase in brain necrosis could result from dose escalation. The significant factors affecting the risk of deafness included age, concurrent chemoradiotherapy, and greater radiation dose to the cochlea. © 2009 Elsevier Inc. All rights reserved. |
Persistent Identifier | http://hdl.handle.net/10722/213920 |
ISSN | 2023 Impact Factor: 6.4 2023 SCImago Journal Rankings: 1.992 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Lee, Anne W M | - |
dc.contributor.author | Ng, W. T. | - |
dc.contributor.author | Hung, W. M. | - |
dc.contributor.author | Choi, C. W. | - |
dc.contributor.author | Tung, Raymond | - |
dc.contributor.author | Ling, Y. H. | - |
dc.contributor.author | Cheng, Peter T C | - |
dc.contributor.author | Yau, T. K. | - |
dc.contributor.author | Chang, Amy T Y | - |
dc.contributor.author | Leung, Samuel K C | - |
dc.contributor.author | Lee, Michael C H | - |
dc.contributor.author | Bentzen, Soren M. | - |
dc.date.accessioned | 2015-08-19T13:41:13Z | - |
dc.date.available | 2015-08-19T13:41:13Z | - |
dc.date.issued | 2009 | - |
dc.identifier.citation | International Journal of Radiation Oncology - Biology - Physics, 2009, v. 73, n. 4, p. 1121-1128 | - |
dc.identifier.issn | 0360-3016 | - |
dc.identifier.uri | http://hdl.handle.net/10722/213920 | - |
dc.description.abstract | Purpose: To retrospectively analyze the factors affecting late toxicity for nasopharyngeal carcinoma. Methods and Materials: Between 1998 and 2003, 422 patients were treated with a conformal technique with 2-Gy daily fractions to a total dose of 70 Gy. Conventional fractionation (5 fractions weekly) was used in 232 patients and accelerated fractionation (6 fractions weekly) in 190 patients. One hundred seventy-one patients were treated with the basic radiotherapy course alone (Group 1), 55 patients had an additional boost of 5 Gy in 2 fractions (Group 2), and 196 patients underwent concurrent cisplatin-based chemotherapy (Group 3). Results: The 5-year overall toxicity rate was significantly greater in Group 3 than in Group 1 (37% vs. 27%, p = 0.009). Although the overall rate in Group 2 was not elevated (28% vs. 27%, p = 0.697), a significant increase in temporal lobe necrosis was observed (4.8% vs. 0%, p = 0.015). Multivariate analyses showed that age and concurrent chemotherapy were significant factors. The hazard ratio of overall toxicity attributed to chemotherapy was 1.99 (95% confidence interval, 1.32-2.99, p = 0.001). The mean radiation dose to the cochlea was another significant factor affecting deafness, with a hazard ratio of 1.03 (95% confidence interval, 1.01-1.05, p = 0.005) per 1-Gy increase. The cochlea that received >50 Gy had a significantly greater deaf rate (Group 1, 18% vs. 7%; and Group 3, 22% vs. 14%). Conclusion: The therapeutic margin for nasopharyngeal carcinoma is extremely narrow, and a significant increase in brain necrosis could result from dose escalation. The significant factors affecting the risk of deafness included age, concurrent chemoradiotherapy, and greater radiation dose to the cochlea. © 2009 Elsevier Inc. All rights reserved. | - |
dc.language | eng | - |
dc.relation.ispartof | International Journal of Radiation Oncology - Biology - Physics | - |
dc.subject | Concurrent chemotherapy | - |
dc.subject | Late toxicity | - |
dc.subject | Nasopharyngeal carcinoma | - |
dc.subject | Radiation boost | - |
dc.title | Major Late Toxicities After Conformal Radiotherapy for Nasopharyngeal Carcinoma-Patient- and Treatment-Related Risk Factors | - |
dc.type | Article | - |
dc.description.nature | link_to_subscribed_fulltext | - |
dc.identifier.doi | 10.1016/j.ijrobp.2008.05.023 | - |
dc.identifier.pmid | 18723296 | - |
dc.identifier.scopus | eid_2-s2.0-61349183760 | - |
dc.identifier.hkuros | 266184 | - |
dc.identifier.volume | 73 | - |
dc.identifier.issue | 4 | - |
dc.identifier.spage | 1121 | - |
dc.identifier.epage | 1128 | - |
dc.identifier.isi | WOS:000264257400025 | - |
dc.identifier.issnl | 0360-3016 | - |