Long-term outcome and late toxicities of simultaneous integrated boost-intensity modulated radiotherapy in pediatric and adolescent nasopharyngeal carcinoma.
- Author:
Chang-Juan TAO
1
,
2
;
Xu LIU
;
Ling-Long TANG
;
Yan-Ping MAO
;
Lei CHEN
;
Wen-Fei LI
;
Xiao-Li YU
;
Li-Zhi LIU
;
Rong ZHANG
;
Ai-Hua LIN
;
Jun MA
;
Ying SUN
Author Information
- Publication Type:Journal Article
- MeSH: Adolescent; Adult; Antineoplastic Combined Chemotherapy Protocols; therapeutic use; Carcinoma; Child; Cisplatin; administration & dosage; Disease-Free Survival; Female; Follow-Up Studies; Humans; Leukopenia; etiology; Lung Neoplasms; secondary; Male; Nasopharyngeal Neoplasms; drug therapy; pathology; radiotherapy; Neoplasm Recurrence, Local; Neoplasm Staging; Neutropenia; etiology; Radiotherapy Dosage; Radiotherapy, Intensity-Modulated; adverse effects; methods; Retrospective Studies; Stomatitis; etiology; Survival Rate; Xerostomia; etiology; Young Adult
- From:Chinese Journal of Cancer 2013;32(10):525-532
- CountryChina
- Language:English
- Abstract: The application of simultaneous integrated boost-intensity modulated radiotherapy (SIB-IMRT) in pediatric and adolescent nasopharyngeal carcinoma (NPC) is underevaluated. This study aimed to evaluate long-term outcome and late toxicities in pediatric and adolescent NPC after SIB-IMRT combined with chemotherapy. Thirty-four patients (aged 8-20 years) with histologically proven, non-disseminated NPC treated with SIB-IMRT were enrolled in this retrospective study. The disease stage distribution was as follows: stage I, 1 (2.9%); stage III, 14 (41.2%); and stage IV, 19 (55.9%). All patients underwent SIB-IMRT and 30 patients also underwent cisplatin-based chemotherapy. The prescribed dose of IMRT was 64-68 Gy in 29-31 fractions to the nasopharyngeal gross target volume. Within the median follow-up of 52 months (range, 9-111 months), 1 patient (2.9%) experienced local recurrence and 4 (11.8%) developed distant metastasis (to the lung in 3 cases and to multiple organs in 1 case). Four patients (11.8%) died due to recurrence or metastasis. The 5-year locoregional relapse-free survival, distant metastasis-free survival, disease-free survival, and overall survival rates were 97.1%, 88.2%, 85.3%, and 88.2%, respectively. The most common acute toxicities were grades 3-4 hematologic toxicities and stomatitis. Of the 24 patients who survived for more than 2 years, 16 (66.7%) and 15 (62.5%) developed grades 1-2 xerostomia and ototoxicity, respectively. Two patients (8.3%) developed grade 3 ototoxicity; no grade 4 toxicities were observed. SIB-IMRT combined with chemotherapy achieves excellent long-term locoregional control in pediatric and adolescent NPC, with mild incidence of late toxicities. Distant metastasis is the predominant mode of failure.
