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Article: Locally recurrent nasopharyngeal carcinoma: Treatment results for patients with computed tomography assessment

TitleLocally recurrent nasopharyngeal carcinoma: Treatment results for patients with computed tomography assessment
Authors
KeywordsComputed tomography
Local recurrence
Nasopharyngeal carcinoma
Reirradiation
Issue Date1998
PublisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/ijrobp
Citation
International Journal of Radiation Oncology - Biology - Physics, 1998, v. 41 n. 2, p. 379-386 How to Cite?
AbstractPurpose: To study the treatment outcome in patients with locally recurrent nasopharyngeal carcinoma as restaged by computed tomography (CT). Patients and Methods: One hundred forty patients with CT restaged locally recurrent nasopharyngeal carcinoma were reviewed. Patients were restaged at recurrence according to the AJCC stage classification with the following distribution: T1-T2:30%, T3:19%, T4:51%. Ninety-seven patients received reirradiation; among these 62 had external irradiation, 34 had brachytherapy, and 1 had both. Twelve patients received surgery. Thirty-one patients were treated with palliative intent and received either chemotherapy or supportive treatment only. Overall survival (OAS) and performance-adjusted survival (PAS, defined as surviving with a Karnofsky performance score [KPS] > 50) were calculated by Kaplan-Meier method. Multivariate analysis was performed using the Cox model. Results: The median survival for all patients was 23.8 months. After reirradiation, the 3-yr and 5-yr OAS rates were 46% and 36%, respectively. The corresponding PAS rates were 40% and 28%. The 3-yr OAS rates for recurrent T1-2, T3, and T4 disease after reirradiation were 71%, 42%, and 30%; the corresponding 5-yr OAS rates were 57%, 42%, 17%. The 3-yr and 5-yr OAS rates in patients receiving palliative treatments only were 19% and 0%, respectively. The 3-yr OAS rate after surgery was 42%. In the multivariate analysis, older age, recurrent T3-4 disease, and palliative treatment were unfavorable factors in predicting overall survival, whereas recurrent T3-4 disease, baseline KPS < 70, and palliative treatment were unfavorable factors in predicting PAS. A high complication rate was observed after reirradiation, with 34% of patients developing neurological sequel. Conclusion: Aggressive treatment for locally recurrent nasopharyngeal carcinoma is warranted especially for those with disease confined to the nasopharynx. Survival after retreatment for more extensive disease remains poor but was still superior to supportive treatment only. Early diagnosis of local recurrence allows prompt administration of treatment and is associated with better outcome. Future studies should aim at improving the therapeutic ratio in the retreatment of recurrent disease especially in patients with more extensive local recurrence.
Persistent Identifierhttp://hdl.handle.net/10722/72024
ISSN
2015 Impact Factor: 4.495
2015 SCImago Journal Rankings: 2.274
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorChua, DTTen_HK
dc.contributor.authorSham, JSTen_HK
dc.contributor.authorKwong, DLWen_HK
dc.contributor.authorWei, WIen_HK
dc.contributor.authorAu, GKHen_HK
dc.contributor.authorChoy, Den_HK
dc.date.accessioned2010-09-06T06:37:36Z-
dc.date.available2010-09-06T06:37:36Z-
dc.date.issued1998en_HK
dc.identifier.citationInternational Journal of Radiation Oncology - Biology - Physics, 1998, v. 41 n. 2, p. 379-386en_HK
dc.identifier.issn0360-3016en_HK
dc.identifier.urihttp://hdl.handle.net/10722/72024-
dc.description.abstractPurpose: To study the treatment outcome in patients with locally recurrent nasopharyngeal carcinoma as restaged by computed tomography (CT). Patients and Methods: One hundred forty patients with CT restaged locally recurrent nasopharyngeal carcinoma were reviewed. Patients were restaged at recurrence according to the AJCC stage classification with the following distribution: T1-T2:30%, T3:19%, T4:51%. Ninety-seven patients received reirradiation; among these 62 had external irradiation, 34 had brachytherapy, and 1 had both. Twelve patients received surgery. Thirty-one patients were treated with palliative intent and received either chemotherapy or supportive treatment only. Overall survival (OAS) and performance-adjusted survival (PAS, defined as surviving with a Karnofsky performance score [KPS] > 50) were calculated by Kaplan-Meier method. Multivariate analysis was performed using the Cox model. Results: The median survival for all patients was 23.8 months. After reirradiation, the 3-yr and 5-yr OAS rates were 46% and 36%, respectively. The corresponding PAS rates were 40% and 28%. The 3-yr OAS rates for recurrent T1-2, T3, and T4 disease after reirradiation were 71%, 42%, and 30%; the corresponding 5-yr OAS rates were 57%, 42%, 17%. The 3-yr and 5-yr OAS rates in patients receiving palliative treatments only were 19% and 0%, respectively. The 3-yr OAS rate after surgery was 42%. In the multivariate analysis, older age, recurrent T3-4 disease, and palliative treatment were unfavorable factors in predicting overall survival, whereas recurrent T3-4 disease, baseline KPS < 70, and palliative treatment were unfavorable factors in predicting PAS. A high complication rate was observed after reirradiation, with 34% of patients developing neurological sequel. Conclusion: Aggressive treatment for locally recurrent nasopharyngeal carcinoma is warranted especially for those with disease confined to the nasopharynx. Survival after retreatment for more extensive disease remains poor but was still superior to supportive treatment only. Early diagnosis of local recurrence allows prompt administration of treatment and is associated with better outcome. Future studies should aim at improving the therapeutic ratio in the retreatment of recurrent disease especially in patients with more extensive local recurrence.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.subjectComputed tomographyen_HK
dc.subjectLocal recurrenceen_HK
dc.subjectNasopharyngeal carcinomaen_HK
dc.subjectReirradiationen_HK
dc.subject.meshAdulten_HK
dc.subject.meshAnalysis of Varianceen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshHumansen_HK
dc.subject.meshMaleen_HK
dc.subject.meshNasopharyngeal Neoplasms - mortality - radiography - radiotherapyen_HK
dc.subject.meshNeoplasm Recurrence, Local - mortality - radiography - radiotherapyen_HK
dc.subject.meshNeoplasm Staging - methodsen_HK
dc.subject.meshPalliative Careen_HK
dc.subject.meshRadiation Injuries - etiologyen_HK
dc.subject.meshSurvival Analysisen_HK
dc.subject.meshTomography, X-Ray Computeden_HK
dc.titleLocally recurrent nasopharyngeal carcinoma: Treatment results for patients with computed tomography assessmenten_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0360-3016&volume=41&spage=379&epage=386&date=1998&atitle=Locally+recurrent+nasopharyngeal+carcinoma:+treatment+results+for+patients+with+computed+tomography+assessmenten_HK
dc.identifier.emailChua, DTT: dttchua@hkucc.hku.hken_HK
dc.identifier.emailKwong, DLW: dlwkwong@hku.hken_HK
dc.identifier.emailWei, WI: hrmswwi@hku.hken_HK
dc.identifier.authorityChua, DTT=rp00415en_HK
dc.identifier.authorityKwong, DLW=rp00414en_HK
dc.identifier.authorityWei, WI=rp00323en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/S0360-3016(98)00063-7en_HK
dc.identifier.pmid9607354-
dc.identifier.scopuseid_2-s2.0-0032076491en_HK
dc.identifier.hkuros34748en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0032076491&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume41en_HK
dc.identifier.issue2en_HK
dc.identifier.spage379en_HK
dc.identifier.epage386en_HK
dc.identifier.isiWOS:000073743100019-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridChua, DTT=7006773480en_HK
dc.identifier.scopusauthoridSham, JST=7101655565en_HK
dc.identifier.scopusauthoridKwong, DLW=15744231600en_HK
dc.identifier.scopusauthoridWei, WI=7403321552en_HK
dc.identifier.scopusauthoridAu, GKH=7003748615en_HK
dc.identifier.scopusauthoridChoy, D=7102939127en_HK

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