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Article: Long term results of radioactive gold grain implantation for the treatment of persistent and recurrent nasopharyngeal carcinoma

TitleLong term results of radioactive gold grain implantation for the treatment of persistent and recurrent nasopharyngeal carcinoma
Authors
KeywordsBrachytherapy
Interstitial implantation
Nasopharyngeal carcinoma
Persistent disease
Recurrence
Issue Date2001
PublisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www3.interscience.wiley.com/cgi-bin/jhome/28741
Citation
Cancer, 2001, v. 91 n. 6, p. 1105-1113 How to Cite?
AbstractBACKGROUND. Brachytherapy is useful for the reirradiation of nasopharyngeal carcinoma. In the current study, the long term treatment results of permanent radioactive gold198 grain interstitial implantation in patients with persistent and recurrent nasopharyngeal carcinoma were reviewed. METHODS. Gold grain implantation was performed under direct vision with a split palate approach to provide 60 grays (Gy) 0.5 cm away from the plane of implantation. Between August 1986 and May 1999, 106 patients were treated with gold grain implantation (45 patients for persistent disease, 53 patients for first recurrence, and 8 patients for second recurrence in the nasopharynx). All patients had histologically proven disease by biopsy before undergoing implantation. RESULTS. Patients with persistent disease and those with first recurrence did well with the gold grain implantation. The 5-year local control rates for patients with persistent disease, first recurrence, and second recurrence in the nasopharynx were 87.2%, 62.7%, and 23.4%, respectively (P = 0.0004). The 5-year metastasis free survival rates were 68.1%, 60.3%, and 40%, respectively, for the 3 groups (P = 0.048). The overall survival rates at 5 years for the 3 groups were 79.1%, 53.6%, and 42.9%, respectively (P = 0.0047). Patients with computed tomography evidence of disease extension outside the nasopharynx had a lower local control rate compared with patients whose disease was confined to the nasopharynx (5-year local control rate of 52% vs. 72.3%; P = 0.031). The size of the lesion was not found to be an independent prognostic factor for local control after implantation. Multivariate analysis showed only an indication for implantation (persistent disease, first recurrence, and second recurrence) to be a significant prognostic factor for local control. Complications attributed to gold grain implantation included headache, palatal fistula, and mucosal radiation necrosis at the site of implantation, and were reported to occur in 28.3%, 18.9%, and 16%, respectively, of patients. CONCLUSIONS. For selected patients with disease confined to the nasopharynx, gold grain implantation is an effective salvage treatment for persistent and recurrent nasopharyngeal carcinoma. © 2001 American Cancer Society.
Persistent Identifierhttp://hdl.handle.net/10722/71905
ISSN
2015 Impact Factor: 5.649
2015 SCImago Journal Rankings: 3.188
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorKwong, DLWen_HK
dc.contributor.authorWei, WIen_HK
dc.contributor.authorCheng, ACKen_HK
dc.contributor.authorChoy, DTKen_HK
dc.contributor.authorLo, ATCen_HK
dc.contributor.authorWu, PMen_HK
dc.contributor.authorSham, JSTen_HK
dc.date.accessioned2010-09-06T06:36:20Z-
dc.date.available2010-09-06T06:36:20Z-
dc.date.issued2001en_HK
dc.identifier.citationCancer, 2001, v. 91 n. 6, p. 1105-1113en_HK
dc.identifier.issn0008-543Xen_HK
dc.identifier.urihttp://hdl.handle.net/10722/71905-
dc.description.abstractBACKGROUND. Brachytherapy is useful for the reirradiation of nasopharyngeal carcinoma. In the current study, the long term treatment results of permanent radioactive gold198 grain interstitial implantation in patients with persistent and recurrent nasopharyngeal carcinoma were reviewed. METHODS. Gold grain implantation was performed under direct vision with a split palate approach to provide 60 grays (Gy) 0.5 cm away from the plane of implantation. Between August 1986 and May 1999, 106 patients were treated with gold grain implantation (45 patients for persistent disease, 53 patients for first recurrence, and 8 patients for second recurrence in the nasopharynx). All patients had histologically proven disease by biopsy before undergoing implantation. RESULTS. Patients with persistent disease and those with first recurrence did well with the gold grain implantation. The 5-year local control rates for patients with persistent disease, first recurrence, and second recurrence in the nasopharynx were 87.2%, 62.7%, and 23.4%, respectively (P = 0.0004). The 5-year metastasis free survival rates were 68.1%, 60.3%, and 40%, respectively, for the 3 groups (P = 0.048). The overall survival rates at 5 years for the 3 groups were 79.1%, 53.6%, and 42.9%, respectively (P = 0.0047). Patients with computed tomography evidence of disease extension outside the nasopharynx had a lower local control rate compared with patients whose disease was confined to the nasopharynx (5-year local control rate of 52% vs. 72.3%; P = 0.031). The size of the lesion was not found to be an independent prognostic factor for local control after implantation. Multivariate analysis showed only an indication for implantation (persistent disease, first recurrence, and second recurrence) to be a significant prognostic factor for local control. Complications attributed to gold grain implantation included headache, palatal fistula, and mucosal radiation necrosis at the site of implantation, and were reported to occur in 28.3%, 18.9%, and 16%, respectively, of patients. CONCLUSIONS. For selected patients with disease confined to the nasopharynx, gold grain implantation is an effective salvage treatment for persistent and recurrent nasopharyngeal carcinoma. © 2001 American Cancer Society.en_HK
dc.languageengen_HK
dc.publisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www3.interscience.wiley.com/cgi-bin/jhome/28741en_HK
dc.relation.ispartofCanceren_HK
dc.subjectBrachytherapyen_HK
dc.subjectInterstitial implantationen_HK
dc.subjectNasopharyngeal carcinomaen_HK
dc.subjectPersistent diseaseen_HK
dc.subjectRecurrenceen_HK
dc.subject.meshBrachytherapy - adverse effects - methods-
dc.subject.meshCarcinoma - pathology - radiotherapy-
dc.subject.meshGold Radioisotopes - therapeutic use-
dc.subject.meshNasopharyngeal Neoplasms - pathology - radiotherapy-
dc.subject.meshNeoplasm Recurrence, Local - pathology - radiotherapy-
dc.titleLong term results of radioactive gold grain implantation for the treatment of persistent and recurrent nasopharyngeal carcinomaen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0008-543X&volume=91&issue=6&spage=1105&epage=1113&date=2001&atitle=Long+term+results+of+radioactive+gold+grain+implantation+for+the+treatment+of+persistent+and+recurrent+nasopharyngeal+carcinomaen_HK
dc.identifier.emailKwong, DLW: dlwkwong@hku.hken_HK
dc.identifier.emailWei, WI: hrmswwi@hku.hken_HK
dc.identifier.authorityKwong, DLW=rp00414en_HK
dc.identifier.authorityWei, WI=rp00323en_HK
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.1002/1097-0142(20010315)91:6<1105::AID-CNCR1106>3.0.CO;2-Zen_HK
dc.identifier.pmid11267955-
dc.identifier.scopuseid_2-s2.0-0035868408en_HK
dc.identifier.hkuros65967en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0035868408&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume91en_HK
dc.identifier.issue6en_HK
dc.identifier.spage1105en_HK
dc.identifier.epage1113en_HK
dc.identifier.isiWOS:000167590400006-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridKwong, DLW=15744231600en_HK
dc.identifier.scopusauthoridWei, WI=7403321552en_HK
dc.identifier.scopusauthoridCheng, ACK=36055097300en_HK
dc.identifier.scopusauthoridChoy, DTK=7102939127en_HK
dc.identifier.scopusauthoridLo, ATC=7102780731en_HK
dc.identifier.scopusauthoridWu, PM=8663653900en_HK
dc.identifier.scopusauthoridSham, JST=7101655565en_HK

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