IS ELECTIVE IRRADIATION TO THE LOWER NECK NECESSARY FOR N0 NASOPHARYNGEAL CARCINOMA?

被引:59
作者
Gao, Yunsheng [1 ]
Zhu, Guopei [1 ]
Lu, Jiade [1 ,2 ]
Ying, Hongmei [1 ]
Kong, Ling [1 ]
Wu, Yongru [1 ]
Hu, Chaosu [1 ]
机构
[1] Fudan Univ, Canc Hosp, Dept Radiat Oncol, Shanghai 200032, Peoples R China
[2] Natl Univ Singapore, Natl Univ Hlth Syst, Natl Univ Canc Inst, Dept Radiat Oncol, Singapore 117548, Singapore
来源
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS | 2010年 / 77卷 / 05期
关键词
Nasopharyngeal carcinoma; Radiotherapy; Lymph node metastasis; POSITRON-EMISSION-TOMOGRAPHY; NODE METASTASIS; F-18-FDG PET; RADIOTHERAPY; CANCER; CHEMOTHERAPY; CT; INVOLVEMENT; INTERGROUP; EXPERIENCE;
D O I
10.1016/j.ijrobp.2009.06.062
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose: To summarize our experience and treatment results in lymph node negative nasopharyngeal carcinoma treated in a single institution. Methods and Materials: From January 2000 to December 2003, 410 patients with lymph node negative nasopharyngeal carcinoma were retrospectively analyzed. The T-stage distribution was 18.8% in T1, 54.6% in T2 (T2a, 41 patients; T2b, 183 patients), 13.2% in T3, and 13.4% in T4. All patients received radiotherapy to the nasopharynx, skull base, and upper neck drainage areas, including levels II, III, and VA. The dose was 64-74 Gy, 1. 8-2.0 Gy per fraction over 6.5-7.5 weeks to the primary tumor with Co-60 or 6-MV X-rays, and 50-56 Gy to levels II, III, and VA. Residual disease was boosted with either Ir-192 afterloading brachytherapy or small external beam fields. Results: The median follow-up time was 54 months (range, 3-90 months). Four patients developed neck recurrence, and only 1 patient (0.2%) experienced relapse outside the irradiation fields. The 5-year overall survival rate was 84.2%. The 5-year relapse-free survival rate, distant metastasis-free survival rate, and disease-free survival rate were 88.6%, 90.6% and 80.1%, respectively. Both univariate and multivariate analyses demonstrated that T classification was the only significant prognostic factor for predicting overall survival. The observed serious late toxicities were radiation-induced brain damage (7 cases), cranial nerve palsy (16 cases), and severe trismus (13 cases; the distance between the incisors was <= 1 cm). Conclusion: Elective levels II, III, and VA irradiation is suitable for nasopharyngeal carcinoma without neck lymph node metastasis. (C) 2010 Elsevier Inc.
引用
收藏
页码:1397 / 1402
页数:6
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