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Article: Whole-Field Simultaneous Integrated-Boost Intensity-Modulated Radiotherapy for Patients With Nasopharyngeal Carcinoma

TitleWhole-Field Simultaneous Integrated-Boost Intensity-Modulated Radiotherapy for Patients With Nasopharyngeal Carcinoma
Authors
Issue Date2010
PublisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/ijrobp
Citation
International Journal of Radiation Oncology - Biology - Physics, 2010, v. 76 n. 1, p. 138-145 How to Cite?
AbstractPurpose: To retrospectively review the outcomes of our patients with newly diagnosed nondisseminated nasopharyngeal carcinoma treated with intensity-modulated radiotherapy using a whole-field simultaneous integrated-boost technique. Methods and Materials: A total of 175 patients treated with WF-SIB between mid-2004 and 2005 were eligible for study inclusion. The distribution of disease by stage was Stage IA in 10.9%, Stage IIA in 2.3%, Stage IIB in 21.7%, Stage III in 41.1%, Stage IVA in 14.9%, and Stage IVB in 9.1%. Of the 175 patients, 2 (1.2%), 10 (5.7%), and 163 (93.1%) had World Health Organization type I, II, and III histologic features, respectively. We prescribed 70 Gy, 60 Gy, and 54 Gy delivered in 33 fractions within 6.5 weeks at the periphery of three planning target volumes (PTV; PTV70, PTV60, and PTV54, respectively). Of the 175 patients, 46 with early T-stage disease received a brachytherapy boost, and 127 with advanced local or regional disease received chemotherapy. Results: The median follow-up period was 34 months. The overall 3-year local failure-free survival, regional failure-free survival, distant failure-free survival, and overall survival rate was 93.6%, 93.3%, 86.6%, and 87.2%, respectively. Cox regression analysis showed Stage N2-N3 disease (p = .029) and PTV (p = .024) to be independent factors predicting a greater risk of distant failure and poor overall survival, respectively. Grade 3 acute mucositis/pharyngitis occurred in 23.4% of patients, and Stage T4 disease was the only significant predictor of mucositis/pharyngitis (p = .021). Conclusion: Whole-field simultaneous integrated-boost intensity-modulated radiotherapy with a dose >70 Gy achieved excellent locoregional control, without an excess incidence of severe, acute mucositis/pharyngitis, in the present study. Strategies for using such highly conformal treatment for patients with a large tumor and late N-stage disease are potential areas of investigation for future studies. © 2010 Elsevier Inc. All rights reserved.
Persistent Identifierhttp://hdl.handle.net/10722/71943
ISSN
2015 Impact Factor: 4.495
2015 SCImago Journal Rankings: 2.274
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorWong, FCSen_HK
dc.contributor.authorNg, AWYen_HK
dc.contributor.authorLee, VHFen_HK
dc.contributor.authorLui, CMMen_HK
dc.contributor.authorYuen, KKen_HK
dc.contributor.authorSze, WKen_HK
dc.contributor.authorLeung, TWen_HK
dc.contributor.authorTung, SYen_HK
dc.date.accessioned2010-09-06T06:36:45Z-
dc.date.available2010-09-06T06:36:45Z-
dc.date.issued2010en_HK
dc.identifier.citationInternational Journal of Radiation Oncology - Biology - Physics, 2010, v. 76 n. 1, p. 138-145en_HK
dc.identifier.issn0360-3016en_HK
dc.identifier.urihttp://hdl.handle.net/10722/71943-
dc.description.abstractPurpose: To retrospectively review the outcomes of our patients with newly diagnosed nondisseminated nasopharyngeal carcinoma treated with intensity-modulated radiotherapy using a whole-field simultaneous integrated-boost technique. Methods and Materials: A total of 175 patients treated with WF-SIB between mid-2004 and 2005 were eligible for study inclusion. The distribution of disease by stage was Stage IA in 10.9%, Stage IIA in 2.3%, Stage IIB in 21.7%, Stage III in 41.1%, Stage IVA in 14.9%, and Stage IVB in 9.1%. Of the 175 patients, 2 (1.2%), 10 (5.7%), and 163 (93.1%) had World Health Organization type I, II, and III histologic features, respectively. We prescribed 70 Gy, 60 Gy, and 54 Gy delivered in 33 fractions within 6.5 weeks at the periphery of three planning target volumes (PTV; PTV70, PTV60, and PTV54, respectively). Of the 175 patients, 46 with early T-stage disease received a brachytherapy boost, and 127 with advanced local or regional disease received chemotherapy. Results: The median follow-up period was 34 months. The overall 3-year local failure-free survival, regional failure-free survival, distant failure-free survival, and overall survival rate was 93.6%, 93.3%, 86.6%, and 87.2%, respectively. Cox regression analysis showed Stage N2-N3 disease (p = .029) and PTV (p = .024) to be independent factors predicting a greater risk of distant failure and poor overall survival, respectively. Grade 3 acute mucositis/pharyngitis occurred in 23.4% of patients, and Stage T4 disease was the only significant predictor of mucositis/pharyngitis (p = .021). Conclusion: Whole-field simultaneous integrated-boost intensity-modulated radiotherapy with a dose >70 Gy achieved excellent locoregional control, without an excess incidence of severe, acute mucositis/pharyngitis, in the present study. Strategies for using such highly conformal treatment for patients with a large tumor and late N-stage disease are potential areas of investigation for future studies. © 2010 Elsevier Inc. All rights reserved.en_HK
dc.languageengen_HK
dc.publisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/ijrobpen_HK
dc.relation.ispartofInternational Journal of Radiation Oncology - Biology - Physicsen_HK
dc.rightsInternational Journal of Radiation: Oncology - Biology - Physics. Copyright © Elsevier Inc.en_HK
dc.subject.meshAdulten_HK
dc.subject.meshAgeden_HK
dc.subject.meshAged, 80 and overen_HK
dc.subject.meshBrachytherapy - methodsen_HK
dc.subject.meshDisease-Free Survivalen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshFollow-Up Studiesen_HK
dc.subject.meshHumansen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshMucositis - etiologyen_HK
dc.subject.meshNasopharyngeal Neoplasms - drug therapy - pathology - radiotherapyen_HK
dc.subject.meshNeoplasm Stagingen_HK
dc.subject.meshPharyngitis - etiologyen_HK
dc.subject.meshRadiotherapy Dosageen_HK
dc.subject.meshRadiotherapy, Intensity-Modulated - adverse effects - methodsen_HK
dc.subject.meshRegression Analysisen_HK
dc.subject.meshRemission Inductionen_HK
dc.subject.meshRetrospective Studiesen_HK
dc.subject.meshTreatment Outcomeen_HK
dc.subject.meshTumor Burdenen_HK
dc.subject.meshYoung Adulten_HK
dc.titleWhole-Field Simultaneous Integrated-Boost Intensity-Modulated Radiotherapy for Patients With Nasopharyngeal Carcinomaen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0360-3016&volume=&spage=available online&epage=&date=2009&atitle=Whole-field+Simultaneous+Integrated-boost+Intensity-modulated+Radiotherapy+for+Patients+with+Nasopharyngeal+Carcinomaen_HK
dc.identifier.emailLee, VHF:vhflee@hkucc.hku.hken_HK
dc.identifier.authorityLee, VHF=rp00264en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/j.ijrobp.2009.01.084en_HK
dc.identifier.pmid19646824-
dc.identifier.scopuseid_2-s2.0-72049091457en_HK
dc.identifier.hkuros165281en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-72049091457&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume76en_HK
dc.identifier.issue1en_HK
dc.identifier.spage138en_HK
dc.identifier.epage145en_HK
dc.identifier.isiWOS:000273442300022-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridWong, FCS=7201409677en_HK
dc.identifier.scopusauthoridNg, AWY=16309934800en_HK
dc.identifier.scopusauthoridLee, VHF=14035860900en_HK
dc.identifier.scopusauthoridLui, CMM=7006066212en_HK
dc.identifier.scopusauthoridYuen, KK=35333348200en_HK
dc.identifier.scopusauthoridSze, WK=7003795949en_HK
dc.identifier.scopusauthoridLeung, TW=7202110934en_HK
dc.identifier.scopusauthoridTung, SY=7102858954en_HK
dc.identifier.citeulike5339342-

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