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. 2017 Aug;143(8):1563-1572.
doi: 10.1007/s00432-017-2401-y. Epub 2017 Mar 25.

A retrospective study comparing the outcomes and toxicities of intensity-modulated radiotherapy versus two-dimensional conventional radiotherapy for the treatment of children and adolescent nasopharyngeal carcinoma

Wen-Ze Qiu  1   2 , Xing-Si Peng  1   2 , Hai-Qun Xia  1   2 , Pei-Yu Huang  1   2 , Xiang Guo  1   2 , Ka-Jia Cao  3   4
Affiliations

A retrospective study comparing the outcomes and toxicities of intensity-modulated radiotherapy versus two-dimensional conventional radiotherapy for the treatment of children and adolescent nasopharyngeal carcinoma

Wen-Ze Qiu et al. J Cancer Res Clin Oncol. 2017 Aug.

Abstract

Purpose: To compare the clinical outcomes and toxicities of two-dimensional conventional radiotherapy (2D-CRT) and intensity-modulated radiotherapy (IMRT) for the treatment of children and adolescent nasopharyngeal carcinoma (NPC).

Methods: A total of 176 children with non-metastatic NPC treated at Sun Yat-sen University Cancer Center between October 2003 and September 2013 were included in this study. Of the 176 patients, 74 received 2D-CRT and 102 were treated with IMRT. The clinical outcomes and acute and late toxicities were determined and compared.

Results: The IMRT group achieved significantly higher overall survival (OS) (90.4% vs. 76.1% at 5 year, P = 0.007) and disease-free survival (DFS) (85.7% vs. 71.2%, P = 0.029) mainly due to an improvement in locoregional relapse-free survival (LRRFS) (97.9 vs. 88.3%, P = 0.049). After stratification by disease stage, IMRT provided significant benefits for patients with stage III-IV disease in terms of OS, LRRFS and DFS. Multivariate analyses indicated that the treatment group (2D-CRT vs. IMRT) was a prognostic factor for OS, LRRFS and DFS. A significant reduction in Grade 2-4 xerostomia (52.7 vs. 34.3%, P = 0.015) and hearing loss (40.5 vs. 22.5%, P = 0.010) was observed in patients treated by IMRT.

Conclusion: IMRT provides better locoregional relapse-free survival and overall survival, especially in late-stage children and adolescent NPC patients, and is associated with a lower incidence of Grade 2-4 xerostomia as well as hearing loss compared with 2D-CRT. Distant metastasis remains a challenge in the treatment of children and adolescent NPC.

Keywords: Children and adolescents; Intensity-modulated radiotherapy; Nasopharyngeal carcinoma; Treatment result; Two-dimensional conventional radiotherapy.

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Conflict of interest statement

No conflicts of interest.

Figures

Fig. 1
Fig. 1
Comparisons of the overall survival (a), locoregional relapse-free survival (b), distant metastasis-free survival (c) and disease-free survival (d) for children and adolescent nasopharyngeal carcinoma (NPC) treated by two-dimensional conventional radiotherapy (2D-CRT) versus intensity-modulated radiotherapy (IMRT)
See this image and copyright information in PMC

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