Patterns of local-regional failure after primary intensity modulated radiotherapy for nasopharyngeal carcinoma
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- 作者：Fangfang Kong (7) (8)
Hongmei Ying (7) (8)
Chengrun Du (7) (8)
Shuang Huang (7) (8)
Junjun Zhou (7) (8)
Junchao Chen (7) (8)
Lining Sun (7) (8)
Xiaohui Chen (7) (8)
Chaosu Hu (7) (8) - 关键词：Intensity ; modulated radiotherapy ; Patterns of local ; regional failure ; Nasopharyngeal carcinoma
- 刊名：Radiation Oncology
- 出版年：2014
- 出版时间：December 2014
- 年：2014
- 卷：9
- 期：1
- 全文大小：1,125 KB
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Hongmei Ying (7) (8)
Chengrun Du (7) (8)
Shuang Huang (7) (8)
Junjun Zhou (7) (8)
Junchao Chen (7) (8)
Lining Sun (7) (8)
Xiaohui Chen (7) (8)
Chaosu Hu (7) (8)
7. Department of Radiation Oncology, Fudan University Shanghai Cancer Center, 270 Dong’an Road, Shanghai, 200032, P.R China
8. Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 20032, P.R China - ISSN：1748-717X
文摘
Background To analyze patterns of local-regional failure after primary intensity modulated radiotherapy (IMRT) for nasopharyngeal carcinoma (NPC). Methods A total of 370 non-metastatic NPC patients consecutively treated with IMRT (with or without chemotherapy) were analyzed. Radiotherapy was administered using a simultaneous integrated boost (SIB) technique at the total prescribed dose of 66-70.4Gy (2.0-2.2Gy per fraction). The location and extent of local-regional failures were transferred to the pretreatment planning computed tomography (CT) for dosimetric analysis. The dose of radiation received by Vrecur (volume of recurrence) was calculated and analyzed with dose-volume histogram (DVH). Failures were classified as: "in field" if 95% of Vrecur was within the 95% isodose, "marginal" if 20% to 95% of Vrecur was within the 95% isodose, or "outside" if less than 20% of Vrecur was inside the 95% isodose. Results With a median follow up of 26?months, 25 local-regional failures were found in 18 patients. The 1- and 2-year actuarial local-regional control rates for all patients were 99.7% and 95.5% respectively. Among the 22 local–regional failures with available diagnostic images, 16 (64%) occurred within the 95% isodose lines and were considered in-field failures; 3 (12%) were marginal and 3 (12%) were outside-field failures. Conclusions Intensity-modulated radiotherapy provides excellent local-regional control for NPC. In-field failures are the main patterns for local-regional recurrence. Reducing the coverage of critical adjacent tissues in CTV purposefully for potential subclinical diseases was worth of study. Great attention in all IMRT steps is necessary to reduce potential causes of marginal failures. More studies about radioresistance are needed to reduce in-field failures.