EXTERNAL BEAM RADIOTHERAPY WITH ENDOCAVITARY BOOST FOR NASOPHARYNGEAL CANCER: TREATMENT RESULTS AND LATE TOXICITY AFTER EXTENDED FOLLOW-UP

作者：Schinagl Dominic A X^*; Marres Henri A M; Kappelle Arnoud C; Merkx Matthias A W; Pop Lucas A M; Verstappen Suzan M M; Kaanders Johannes H A M

来源：International Journal of Radiation Oncology, Biology, Physics, 2010, 78(3): 689-695.

DOI：10.1016/j.ijrobp.2009.08.072

• Nasopharyngeal cancer
• radiotherapy
• endocavitary brachytherapy
• late toxicity
• multidisciplinary clinic

Purpose: To evaluate the long-term outcome after treatment of nasopharyngeal carcinoma and assess late toxicity in a multidisciplinary clinic.
Methods and Materials: A retrospective analysis of 117 patients treated for nasopharyngeal cancer in a single institute between 1985 and 2002 was performed. Fifty-one long-term survivors were evaluated for late toxicity by a multidisciplinary team comprising a radiation oncologist, otolaryngologist, neurologist, and oral and maxillofacial surgeon.
Results: The 5-year local control rate for T1 to T2 and T3 to T4 tumors was 97% and 76%, respectively. Five-year disease-free survival and overall survival were 82% and 88% for Stage I to lib disease and 46% and 52% for Stage III to IVb, respectively. Late morbidity evaluation revealed Radiation Therapy Oncology Group (RTOG) Grade III to IV toxicity in 71% of patients. A high incidence of cranial nerve palsies (47%) and mandibular osteolysis (82%) was found, although these complications had limited clinical impact.
Conclusions: The multidisciplinary late morbidity clinic revealed an unexpected high incidence of cranial nerve palsies and mandibular osteolysis and overall an RTOG Grade III to IV toxicity in 71% of patients treated for nasopharyngeal cancer. External beam radiotherapy with endocavitary brachytherapy produces excellent rates of local control for T1 to T2 tumors, but the high incidence of late toxicity suggests an overtreatment.

• 出版日期2010-11-1