Outcomes and prognostic factors of conformal radiotherapy versus intensity-modulated radiotherapy for nasopharyngeal carcinoma

被引:30
作者
Kuang, Wei Lu [1 ]
Zhou, Qin [1 ]
Shen, Liang Fang [1 ]
机构
[1] Cent S Univ, Xiangya Hosp, Dept Oncol, Changsha 410008, Hunan, Peoples R China
关键词
Nasopharyngeal carcinoma; Conformal radiotherapy; Intensity-modulated radiotherapy; RADIATION-THERAPY; RANDOMIZED-TRIALS; NECK-CANCER; CHEMOTHERAPY; EXPERIENCE; METAANALYSIS; MANAGEMENT; UPDATE; HEAD;
D O I
10.1007/s12094-012-0864-5
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
This study retrospectively compared outcomes and prognostic factors of nasopharyngeal carcinoma (NPC) treated with conformal radiotherapy (CRT) and intensity-modulated radiotherapy (IMRT). The treatment records of 182 patients treated with IMRT and 198 patients treated with CRT from April 2005 to December 2007 in our hospital were reviewed. The clinical characteristics, treatment outcomes (including survival analysis and acute and late toxicity), and prognostic factors of the two groups were compared. The 4-year local-regional control (LRC), distant metastasis-free survival (DMFS), disease-free survival (DFS), and overall survival (OS) of the IMRT and CRT groups were 93.6 and 85.3 %, 79.1 and 73.6 %, 74.7 and 65.0 %, and 83.5 and 72.1 %, respectively. The acute radiation dermatitis and xerostomia of the two groups were significantly different (P < 0.05). In the IMRT group, OS between different T stages could not be well separated. Multivariate analysis revealed that, in the CRT group, the clinical stage and T and N stages were significant prognostic factors for OS, DMFS, and DFS and that T stage was a significant prognostic factor for LRC. In the IMRT group, T and N stages had no predictive value for outcomes. Compared with CRT, IMRT has a better prognosis and less adverse effects. For IMRT, T stage was not a significant prognostic factor for LRC, DMFS, DFS, or OS. An effective treatment strategy is needed for distant control. With the increasing use of IMRT and continued modulation of treatment strategies for NPC, the current staging system faces great challenges.
引用
收藏
页码:783 / 790
页数:8
相关论文
共 24 条
[1]   Chemotherapy in locally advanced nasopharyngeal carcinoma: An individual patient data meta-analysis of eight randomized trials and 1753 patients [J].
Baujat, B ;
Audry, W ;
Bourhis, J ;
Chan, ATC ;
Onat, H ;
Chua, DTT ;
Kwong, DLW ;
al-Sarraf, M ;
Chi, KH ;
Hareyama, M ;
Leung, SF ;
Thephamongkhol, K ;
Pignon, JP .
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 2006, 64 (01) :47-56
[2]   Smart (simultaneous modulated accelerated radiation therapy) boost: A new accelerated fractionation schedule for the treatment of head and neck cancer with intensity modulated radiotherapy [J].
Butler, EB ;
Teh, BS ;
Grant, WH ;
Uhl, BM ;
Kuppersmith, RB ;
Chiu, JK ;
Donovan, DT ;
Woo, SY .
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 1999, 45 (01) :21-32
[3]   A phase III study of adjuvant chemotherapy in advanced nasopharyngeal carcinoma patients [J].
Chi, KH ;
Chang, YC ;
Guo, WY ;
Leung, MJ ;
Shiau, CY ;
Chen, SY ;
Wang, LW ;
Lai, YL ;
Hsu, MM ;
Lian, SL ;
Chang, CH ;
Liu, TW ;
Chin, YH ;
Yen, SH ;
Perng, CH ;
Chen, KY .
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 2002, 52 (05) :1238-1244
[4]  
Han Lu, 2010, Chin J Cancer, V29, P145
[5]   Randomized Phase II Trial of Concurrent Cisplatin-Radiotherapy With or Without Neoadjuvant Docetaxel and Cisplatin in Advanced Nasopharyngeal Carcinoma [J].
Hui, Edwin P. ;
Ma, Brigette B. ;
Leung, Sing F. ;
King, Ann D. ;
Mo, Frankie ;
Kam, Michael K. ;
Yu, Brian K. ;
Chiu, Samuel K. ;
Kwan, Wing H. ;
Ho, Rosalie ;
Chan, Iris ;
Ahuja, Anil T. ;
Zee, Benny C. ;
Chan, Anthony T. .
JOURNAL OF CLINICAL ONCOLOGY, 2009, 27 (02) :242-249
[6]   Combined chemoradiation versus radiation therapy alone in locally advanced nasopharyngeal carcinoma - Results of a meta-analysis of 1,528 patients from six randomized trials [J].
Huncharek, M ;
Kupelnick, B .
AMERICAN JOURNAL OF CLINICAL ONCOLOGY-CANCER CLINICAL TRIALS, 2002, 25 (03) :219-223
[7]   Trends in incidence and mortality of nasopharyngeal carcinoma over a 20-25 year period (1978/1983-2002) in Sihui and Cangwu counties in southern China [J].
Jia, Wei-Hua ;
Huang, Qi-Hong ;
Liao, Jian ;
Ye, Weimin ;
Shugart, Y. Y. ;
Liu, Qing ;
Chen, Li-Zhen ;
Li, Yan-Hua ;
Lin, Xiao ;
Wen, Fa-Lin ;
Adami, Hans-Olov ;
Zeng, Yi ;
Zeng, Yi-Xin .
BMC CANCER, 2006, 6 (1)
[8]   Treatment of nasopharyngeal carcinoma with intensity-modulated radiotherapy: The Hong Kong experience [J].
Kam, MKM ;
Teo, PML ;
Chau, RMC ;
Cheung, KY ;
Choi, PHK ;
Kwan, WH ;
Leung, SF ;
Zee, B ;
Chan, ATC .
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 2004, 60 (05) :1440-1450
[9]   Intensity-modulated radiotherapy for early-stage nasopharyngeal carcinoma - A prospective study on disease control and preservation of salivary function [J].
Kwong, DLW ;
Pow, EHN ;
Sham, JST ;
McMillan, AS ;
Leung, LHT ;
Leung, WK ;
Chua, DTT ;
Cheng, ACK ;
Wu, PM ;
Au, GKH .
CANCER, 2004, 101 (07) :1584-1593
[10]   The additional value of chemotherapy to radiotherapy in locally advanced nasopharyngeal carcinoma: A meta-analysis of the published literature [J].
Langendijk, JA ;
Leemans, CR ;
Buter, J ;
Berkhof, J ;
Slotman, BJ .
JOURNAL OF CLINICAL ONCOLOGY, 2004, 22 (22) :4604-4612