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Article: Comparison of single versus fractionated dose of stereotactic radiotherapy for salvaging local failures of nasopharyngeal carcinoma: a matched-cohort analysis.

TitleComparison of single versus fractionated dose of stereotactic radiotherapy for salvaging local failures of nasopharyngeal carcinoma: a matched-cohort analysis.
Authors
Issue Date2009
PublisherBioMed Central Ltd.. The Journal's web site is located at http://www.headandneckoncology.org
Citation
Head & Neck Oncology, 2009, v. 1, p. 13 How to Cite?
AbstractBACKGROUND: Local failure is an important cause of morbidity and mortality in nasopharyngeal carcinoma (NPC). Although surgery or brachytherapy may be feasible in selected cases, most patients with local failure require external beam re-irradiation. Stereotactic radiation using single or multiple fractions have been employed in re-irradiation of NPC, but the optimal fractionation scheme and dose are not clear. METHODS: Records of 125 NPC patients who received salvage stereotactic radiation were reviewed. A matched-pair design was used to select patients with similar prognostic factors who received stereotactic re-irradiation using single fraction (SRS) or multiple fractions (SRM). Eighty-six patients were selected with equal number in SRS and SRM groups. All patients were individually matched for failure type (persistent or recurrent), rT stage (rT1-2 or rT3-4), and tumor volume (< or = 5 cc, >5-10 cc, or >10 cc). Median dose was 12.5 Gy in single fraction by SRS, and 34 Gy in 2-6 fractions by SRM. RESULTS: Local control rate was better in SRM group although overall survival rates were similar. One- and 3-year local failure-free rates were 70% and 51% in SRS group compared with 91% and 83% in SRM group (p = 0.003). One- and 3-year overall survival rates were 98% and 66% in SRS group compared with 78% and 61% in SRM group (p = 0.31). The differences in local control were mainly observed in recurrent or rT2-4 disease. Incidence of severe late complications was 33% in SRS group vs. 21% in SRM group, including brain necrosis (16% vs. 12%) and hemorrhage (5% vs. 2%). CONCLUSION: Our study showed that SRM was superior to SRS in salvaging local failures of NPC, especially in the treatment of recurrent and rT2-4 disease. In patient with local failure of NPC suitable for stereotactic re-irradiation, use of fractionated treatment is preferred.
Persistent Identifierhttp://hdl.handle.net/10722/58607
ISSN
2013 SCImago Journal Rankings: 0.729
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorChua, DTen_HK
dc.contributor.authorWu, SXen_HK
dc.contributor.authorLee, Ven_HK
dc.contributor.authorTsang, Jen_HK
dc.date.accessioned2010-05-31T03:33:24Z-
dc.date.available2010-05-31T03:33:24Z-
dc.date.issued2009en_HK
dc.identifier.citationHead & Neck Oncology, 2009, v. 1, p. 13en_HK
dc.identifier.issn1758-3284en_HK
dc.identifier.urihttp://hdl.handle.net/10722/58607-
dc.description.abstractBACKGROUND: Local failure is an important cause of morbidity and mortality in nasopharyngeal carcinoma (NPC). Although surgery or brachytherapy may be feasible in selected cases, most patients with local failure require external beam re-irradiation. Stereotactic radiation using single or multiple fractions have been employed in re-irradiation of NPC, but the optimal fractionation scheme and dose are not clear. METHODS: Records of 125 NPC patients who received salvage stereotactic radiation were reviewed. A matched-pair design was used to select patients with similar prognostic factors who received stereotactic re-irradiation using single fraction (SRS) or multiple fractions (SRM). Eighty-six patients were selected with equal number in SRS and SRM groups. All patients were individually matched for failure type (persistent or recurrent), rT stage (rT1-2 or rT3-4), and tumor volume (< or = 5 cc, >5-10 cc, or >10 cc). Median dose was 12.5 Gy in single fraction by SRS, and 34 Gy in 2-6 fractions by SRM. RESULTS: Local control rate was better in SRM group although overall survival rates were similar. One- and 3-year local failure-free rates were 70% and 51% in SRS group compared with 91% and 83% in SRM group (p = 0.003). One- and 3-year overall survival rates were 98% and 66% in SRS group compared with 78% and 61% in SRM group (p = 0.31). The differences in local control were mainly observed in recurrent or rT2-4 disease. Incidence of severe late complications was 33% in SRS group vs. 21% in SRM group, including brain necrosis (16% vs. 12%) and hemorrhage (5% vs. 2%). CONCLUSION: Our study showed that SRM was superior to SRS in salvaging local failures of NPC, especially in the treatment of recurrent and rT2-4 disease. In patient with local failure of NPC suitable for stereotactic re-irradiation, use of fractionated treatment is preferred.en_HK
dc.languageengen_HK
dc.publisherBioMed Central Ltd.. The Journal's web site is located at http://www.headandneckoncology.orgen_HK
dc.relation.ispartofHead & neck oncologyen_HK
dc.titleComparison of single versus fractionated dose of stereotactic radiotherapy for salvaging local failures of nasopharyngeal carcinoma: a matched-cohort analysis.en_HK
dc.typeArticleen_HK
dc.identifier.emailChua, DT: dttchua@hkucc.hku.hken_HK
dc.identifier.emailLee, V: vhflee@hku.hken_HK
dc.identifier.emailTsang, J: jwhtsang@hku.hken_HK
dc.identifier.authorityChua, DT=rp00415en_HK
dc.identifier.authorityLee, V=rp00264en_HK
dc.identifier.authorityTsang, J=rp00278en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.pmid19463191en_HK
dc.identifier.scopuseid_2-s2.0-77957964200en_HK
dc.identifier.hkuros158402en_HK
dc.identifier.volume1en_HK
dc.identifier.spage13en_HK
dc.identifier.epage13en_HK
dc.identifier.isiWOS:000208107000013-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridChua, DT=7006773480en_HK
dc.identifier.scopusauthoridWu, SX=36341755400en_HK
dc.identifier.scopusauthoridLee, V=14035860900en_HK
dc.identifier.scopusauthoridTsang, J=35141929400en_HK

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