Hyperfractionation compared to standard fractionation in intensity-modulated radiation therapy for patients with locally advanced recurrent nasopharyngeal carcinoma

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• 作者：Victor H. F. Lee ; Dora L. W. Kwong…
• 关键词：Nasopharyngeal carcinoma ; Locally advanced recurrence ; Hyperfractionation ; Standard fractionation ; Intensity ; modulated radiation therapy ; Re ; irradiation
• 刊名：European Archives of Oto-Rhino-Laryngology
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：274
• 期：2
• 页码：1067-1078
• 全文大小：
• 刊物类别：Medicine
• 刊物主题：Otorhinolaryngology; Neurosurgery; Head and Neck Surgery;
• 出版者：Springer Berlin Heidelberg
• ISSN：1434-4726
• 卷排序：274

文摘

We prospectively studied the efficacy and safety of hyperfractionated intensity-modulated radiation therapy (HF-IMRT) and compared to a historical cohort treated with standard fractionation (SF-IMRT) in patients with locally advanced recurrent (rT3–T4, rN0–N1, M0) nasopharyngeal carcinoma (NPC). Ten patients were treated with induction chemotherapy followed by HF-IMRT (64.8 Gy/54 fr/5.5 weeks) concurrent with weekly cisplatin. They were compared to another ten patients treated with induction chemotherapy followed by SF-IMRT (60 Gy/30 fr/6 weeks) concurrent with weekly cisplatin. After a median follow-up duration of 44.6 months, we demonstrated that the median local failure-free survival (LFFS) showed a trend in favor of HF-IMRT (28.2 vs. 16.6 months, p = 0.164). Overall survival (OS) (34.8 vs. 35.5 months, p = 0.603) was not different between the two groups. Treatment-related hemorrhage was slightly less with HF-IMRT (30.0 vs. 0 %), reaching marginal significance (p = 0.060). Judging from our study results, HF-IMRT offered a marginally better LFFS and an apparently more favorable toxicity profile compared to SF-IMRT in locally advanced recurrent NPC.