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Conference Paper: Comparison of Hyperfractionated to Conventionally Fractionated Salvage IMRT for Locoregionally Advanced Recurrent Nasopharyngeal Carcinoma

TitleComparison of Hyperfractionated to Conventionally Fractionated Salvage IMRT for Locoregionally Advanced Recurrent Nasopharyngeal Carcinoma
Authors
Issue Date2015
PublisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/ijrobp
Citation
The 57th Annual Meeting of the American Society for Radiation Oncology (ASTRO 2015), San Antonio, TX., 18–21 October 2015. In International Journal of Radiation Oncology - Biology - Physics, 2015, v. 93 n. 3 suppl., p. E291, abstract no. 2724 How to Cite?
AbstractPURPOSE/OBJECTIVE(S): Salvage intensity modulated radiation therapy (IMRT) for locoregionally advanced recurrent nasopharyngeal carcinoma (NPC) is always challenging due to the inherently high dose received by the nearby organs at risk (OARs) in the first course of radiation therapy. We prospectively studied the efficacy and safety of hyperfractionated (HF) IMRT and compared to a historical cohort treated with conventionally fractionated (CF) IMRT. MATERIALS/METHODS: Ten consecutive patients with locoregionally advanced (T3-T4, N0-N1, M0) NPC prospectively recruited and treated with induction chemotherapy gemcitabine/platinum for 3 cycles followed by 9-field (HF-IMRT) (64.8 Gy/54 fr/5.5 weeks, twice daily, interfractional interval 37 hours) concurrent with weekly platinum for 6 cycles. Objective response rate (ORR), local failure-free survival (LFFS), regional failure-free survival (RFFS), overall survival (OS) and treatment-related complications were compared to a historical cohort of another 10 patients in the same setting treated with 3 cycles of induction chemotherapy followed by CF-IMRT (60 Gy/30 fr/6 weeks). RESULTS: Median age was 59.5 years (HF-IMRT) and 44.0 years (CF-IMRT, P=.764). After a median follow up of 27.9 months (range 5.2 to 69.0 months), ORR were 40.0% (HF-IMRT) and 30.0% (CF-IMRT, P=.871) respectively. Median LFFS showed a trend in favor of HF-IMRT (33.6 months [95% CI 12.2–55.1 months] vs 14.8 months [95% CI 14.1–15.4 months], P=.179). RFFS (40.8 months vs not reached, P=.857) and OS (31.9 months vs 34.3 months, P=.681) were not different between the 2 groups. Commonest chronic treatment-related complications were brain necrosis (10.0% in HF-IMRT vs 20.0% in CF-IMRT; P=.531), aspiration pneumonia (40.0% in HF-IMRT vs 20.0% in CF-IMRT; P=.329) and hemorrhage (0% in HF-IMRT vs 30.0% in CF-IMRT; P=.060). CONCLUSION: HF-IMRT offered marginally better LFFS and relatively less treatment-related hemorrhage compared to CF-IMRT in locoregionally advanced recurrent NPC.
DescriptionPoster Viewing Session
This journal suppl. entitled: Proceedings of the American Society for Radiation Oncology 57th Annual Meeting, ASTRO's 57th Annual Meeting
Persistent Identifierhttp://hdl.handle.net/10722/241009
ISSN
2017 Impact Factor: 5.554
2015 SCImago Journal Rankings: 2.274
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLee, VHF-
dc.contributor.authorKwong, DLW-
dc.contributor.authorNg, SCY-
dc.contributor.authorLam, KO-
dc.contributor.authorSze, CKH-
dc.contributor.authorHo, PYP-
dc.contributor.authorChan, WLW-
dc.contributor.authorWong, LS-
dc.contributor.authorLeung, DK-
dc.contributor.authorChan, AS-
dc.contributor.authorChan, FT-
dc.contributor.authorLau, KS-
dc.contributor.authorLeung, TW-
dc.date.accessioned2017-05-22T09:21:01Z-
dc.date.available2017-05-22T09:21:01Z-
dc.date.issued2015-
dc.identifier.citationThe 57th Annual Meeting of the American Society for Radiation Oncology (ASTRO 2015), San Antonio, TX., 18–21 October 2015. In International Journal of Radiation Oncology - Biology - Physics, 2015, v. 93 n. 3 suppl., p. E291, abstract no. 2724-
dc.identifier.issn0360-3016-
dc.identifier.urihttp://hdl.handle.net/10722/241009-
dc.descriptionPoster Viewing Session-
dc.descriptionThis journal suppl. entitled: Proceedings of the American Society for Radiation Oncology 57th Annual Meeting, ASTRO's 57th Annual Meeting-
dc.description.abstractPURPOSE/OBJECTIVE(S): Salvage intensity modulated radiation therapy (IMRT) for locoregionally advanced recurrent nasopharyngeal carcinoma (NPC) is always challenging due to the inherently high dose received by the nearby organs at risk (OARs) in the first course of radiation therapy. We prospectively studied the efficacy and safety of hyperfractionated (HF) IMRT and compared to a historical cohort treated with conventionally fractionated (CF) IMRT. MATERIALS/METHODS: Ten consecutive patients with locoregionally advanced (T3-T4, N0-N1, M0) NPC prospectively recruited and treated with induction chemotherapy gemcitabine/platinum for 3 cycles followed by 9-field (HF-IMRT) (64.8 Gy/54 fr/5.5 weeks, twice daily, interfractional interval 37 hours) concurrent with weekly platinum for 6 cycles. Objective response rate (ORR), local failure-free survival (LFFS), regional failure-free survival (RFFS), overall survival (OS) and treatment-related complications were compared to a historical cohort of another 10 patients in the same setting treated with 3 cycles of induction chemotherapy followed by CF-IMRT (60 Gy/30 fr/6 weeks). RESULTS: Median age was 59.5 years (HF-IMRT) and 44.0 years (CF-IMRT, P=.764). After a median follow up of 27.9 months (range 5.2 to 69.0 months), ORR were 40.0% (HF-IMRT) and 30.0% (CF-IMRT, P=.871) respectively. Median LFFS showed a trend in favor of HF-IMRT (33.6 months [95% CI 12.2–55.1 months] vs 14.8 months [95% CI 14.1–15.4 months], P=.179). RFFS (40.8 months vs not reached, P=.857) and OS (31.9 months vs 34.3 months, P=.681) were not different between the 2 groups. Commonest chronic treatment-related complications were brain necrosis (10.0% in HF-IMRT vs 20.0% in CF-IMRT; P=.531), aspiration pneumonia (40.0% in HF-IMRT vs 20.0% in CF-IMRT; P=.329) and hemorrhage (0% in HF-IMRT vs 30.0% in CF-IMRT; P=.060). CONCLUSION: HF-IMRT offered marginally better LFFS and relatively less treatment-related hemorrhage compared to CF-IMRT in locoregionally advanced recurrent NPC.-
dc.languageeng-
dc.publisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/ijrobp-
dc.relation.ispartofInternational Journal of Radiation Oncology - Biology - Physics-
dc.rightsPosting accepted manuscript (postprint): © 2015. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/-
dc.titleComparison of Hyperfractionated to Conventionally Fractionated Salvage IMRT for Locoregionally Advanced Recurrent Nasopharyngeal Carcinoma-
dc.typeConference_Paper-
dc.identifier.emailLee, VHF: vhflee@hku.hk-
dc.identifier.emailKwong, DLW: dlwkwong@hku.hk-
dc.identifier.emailNg, SCY: ngchoryi@hku.hk-
dc.identifier.emailLam, KO: lamkaon@hku.hk-
dc.identifier.emailSze, CKH: henrysze@graduate.hku.hk-
dc.identifier.emailHo, PYP: pattyho@hku.hk-
dc.identifier.emailChan, WLW: winglok@hku.hk-
dc.identifier.emailLeung, TW: ltw920@hkucc.hku.hk-
dc.identifier.authorityLee, VHF=rp00264-
dc.identifier.authorityKwong, DLW=rp00414-
dc.identifier.authorityLam, KO=rp01501-
dc.identifier.authoritySze, CKH=rp01697-
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.1016/j.ijrobp.2015.07.1280-
dc.identifier.hkuros272222-
dc.identifier.volume93-
dc.identifier.issue3 suppl.-
dc.identifier.spageE291, abstract no. 2724-
dc.identifier.epageE291, abstract no. 2724-
dc.identifier.isiWOS:000373215300720-
dc.publisher.placeUnited States-

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