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. 2014 Mar 7;9(3):e91362.
doi: 10.1371/journal.pone.0091362. eCollection 2014.

Effectiveness and toxicities of intensity-modulated radiation therapy for patients with T4 nasopharyngeal carcinoma

Fang-Fang Kong  1 , Hongmei Ying  1 , Cheng-Run Du  1 , Shuang Huang  1 , Jun-Jun Zhou  1 , Chao-Su Hu  1
Affiliations

Effectiveness and toxicities of intensity-modulated radiation therapy for patients with T4 nasopharyngeal carcinoma

Fang-Fang Kong et al. PLoS One. .

Abstract

Objective: To evaluate the effectiveness and toxicities in T4 nasopharyngeal carcinoma (NPC) using intensity-modulated radiotherapy (IMRT) combined with chemotherapy.

Methods: This is a retrospective analysis of 81 patients treated with intensity-modulated radiotherapy (IMRT). All the primary tumors were attributed to T4 stage according to the AJCC2010 staging system. And the distribution of disease by N stage was N0 in 13.6%, N1 in 30.9%, N2 in 37%, and N3 in 18.5%. Cisplatin-based chemotherapy was offered to all patients. Radiotherapy-related toxicities were graded according to the Acute and the Late Radiation Morbidity Scoring Criteria of the Radiation Therapy Oncology Group (RTOG) scoring criteria. Chemotherapy-related toxicities were graded by National Cancer Institute Common Toxicity Criteria (NCI-CTC) version 3.0. Prognostic factors were assessed by univariate analysis.

Results: With a median follow-up of 37 months, 12 patients experienced local regional failure and total distant metastasis occurred in 18 patients, representing the major mode of failure. Ten patients died. Among them, 70% died of distant metastasis. The 3-year actuarial rates of local failure-free survival (LFFS), regional failure-free survival (RFFS), distant failure-free survival (DFFS), overall survival (OS), and progression-free survival (PFS) were 83.8%, 97.4%, 81.3%, 90%, and 69.7%, respectively. Acute and late toxicities were mild or moderate.

Conclusions: IMRT provides excellent local-regional control for T4 NPC. Distant metastasis remains the major cause of treatment failure. Further explorations of the sequence and regimen of systemic therapy are needed in the future.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Kaplan-Meier curves showing local failure-free survival (LFFS), regional failure-free survival (RFFS), distant failure-free survival (DFFS), overall survival (OS), and progression-free survival (PFS) of patients.
Figure 2
Figure 2. Kaplan-Meier curves showing distant failure-free survival (DFFS) between N0–1 and N2–3 patients.
See this image and copyright information in PMC

References

    1. Lu H, Yao M (2008) The current status of intensity-modulated radiation therapy in the treatment of nasopharyngeal carcinoma. Cancer Treat Rev 34: 27–36. - PubMed
    1. Teo P, Yu P, Lee WY, Leung SF, Kwan WH, et al. (1996) Significant prognosticators after primary radiotherapy in 903 nondisseminated nasopharyngeal carcinoma evaluated by computer tomography. Int J Radiat Oncol Biol Phys 36: 291–304. - PubMed
    1. Sanguineti G, Geara FB, Garden AS, Tucker SL, Ang KK, et al. (1997) Carcinoma of the nasopharynx treated by radiotherapy alone: determinants of local and regional control. Int J Radiat Oncol Biol Phys 37: 985–996. - PubMed
    1. Lee AW, Au JS, Teo PM, Leung TW, Chua DT, et al. (2004) Staging of nasopharyngeal carcinoma: suggestions for improving the current UICC/AJCC Staging System. Clin Oncol (R Coll Radiol) 16: 269–276. - PubMed
    1. Yi JL, Gao L, Huang XD, Li SY, Luo JW, et al. (2006) Nasopharyngeal carcinoma treated by radical radiotherapy alone: Ten-year experience of a single institution. Int J Radiat Oncol Biol Phys 65: 161–168. - PubMed

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