Intensity modulated radiation therapy for 49 patients with recurrent nasopharyngeal carcinoma.
- Author:
Tai-xiang LU
1
;
Chong ZHAO
;
Fei HAN
;
Ying HUANG
;
Xiao-wu DENG
;
Li-xia LU
;
Zhi-fan ZENG
;
Shao-min HUANG
;
Cheng-guang LIN
;
Nian-ji CUI
Author Information
- Publication Type:Journal Article
- MeSH: Adult; Aged; Carcinoma, Squamous Cell; pathology; radiotherapy; Female; Follow-Up Studies; Humans; Lymphatic Metastasis; Male; Middle Aged; Nasopharyngeal Neoplasms; pathology; radiotherapy; Neoplasm Recurrence, Local; radiotherapy; Neoplasm Staging; Radiation Injuries; pathology; Radiotherapy Dosage; Radiotherapy Planning, Computer-Assisted; Radiotherapy, Conformal; methods
- From: Chinese Journal of Oncology 2003;25(4):386-389
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVETo evaluate the feasibility, toxicity and tumor control of intensity modulated radiation therapy (IMRT) for recurrent nasopharyngeal carcinoma.
METHODSFourty-nine patients (Karnofsky performance status (KPS) >or= 80) with local-regional recurrence in the nasopharynx were treated with full course IMRT. Three patients with cervical lymph node metastasis (N1 2 and N3 1) were further supplemented with 5 to 6 courses of chemotherapy (Cisplatin + 5-Fu) after IMRT.
RESULTSThe results of treatment plan showed that the mean dose of covering gross tumor volume (GTV) (D(95)) in the nasopharynx was 68.09 Gy and the mean volume of GTV (V(95)) receiving the 95% dose was 98.46%. The mean dose of GTV, clinical target volume CTV1 and CTV2 in the targets were 71.40 Gy, 63.63 Gy and 59.81 Gy. The median follow-up time was 9 months (range 3 to 16 months). The local-regional progression-free survival was 100% with local-regional residual disease in 3 (6.1%) cases but was complicated with nasopharyngeal mucosa necrosis in 14 (28.6%) cases after IMRT.
CONCLUSIONIntensity modulated radiation therapy, as a re-treatment option for recurrent nasopharyngeal carcinoma, is able to improve the tumor target coverage and spare the adjacent critical structures. As high dose IMRT can result in radio-necrosis of nasopharyngeal mucosa, the prescription dose of GTV should be suitably decreased to 60 - 65 Gy.
