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. 2017 Oct 17;8(18):3718-3724.
doi: 10.7150/jca.20351. eCollection 2017.

Survival and Toxicities of IMRT Based on the RTOG Protocols in Patients with Nasopharyngeal Carcinoma from the Endemic Regions of China

Shao-Bo Liang  1   2 , Yan Wang  3 , Xue-Feng Hu  1 , Sha-Sha He  2 , Xing-Li Yang  2 , Li-Zhi Liu  2 , Chun-Yan Cui  2 , Yong Chen  3 , Li-Wu Fu  2
Affiliations

Survival and Toxicities of IMRT Based on the RTOG Protocols in Patients with Nasopharyngeal Carcinoma from the Endemic Regions of China

Shao-Bo Liang et al. J Cancer. .

Abstract

Background: This study evaluated the survival outcomes and toxicities of intensity-modulated radiation therapy (IMRT) based on the RTOG 0225/0615 RT protocols in patients with nasopharyngeal carcinoma (NPC) from a region of China where this tumor type is endemic. Methods: A total of 455 patients with non-metastatic, histologically-confirmed NPC were retrospectively reviewed. All patients were treated by IMRT using the RTOG 0225/0615 RT protocols; 91.1% (288/316) of patients with stage III-IVb NPC received concurrent chemotherapy +/- induction chemotherapy or adjuvant chemotherapy. Results: Estimated four-year overall survival (OS), failure free survival (FFS), local relapse free survival (LRFS), regional relapse free survival (RRFS) and distant metastasis free survival (DMFS) were 83.8%, 80.5%, 94.3%, 96.7% and 85.8%, respectively. T and N category were significant prognostic factors for OS, FFS, RRFS and DMFS; and T category, for LRFS. In-field failure was the major loco-regional failure pattern. During RT, 206 (45.3%) patients experienced acute grade 3-4 toxicities. The most common acute toxicity was mucositis; 124 (27.2%) patients experienced grade 3-4 mucositis; 46 (10.1%) experienced serious late toxicities. The most common late toxicity was MRI-detected radiation-induced temporal lobe necrosis (6.8%). Conclusions: The RTOG IMRT protocols are feasible for patients with NPC from the endemic regions of China.

Keywords: Nasopharyngeal carcinoma; RTOG 0225; RTOG 0615.; intensity-modulated radiotherapy.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interest exists.

Figures

Figure 1
Figure 1
Failure patterns for the 90 patients with nasopharyngeal carcinoma who experienced treatment failure.
Figure 2
Figure 2
Overall survival and failure-free survival for 455 patients with nasopharyngeal carcinoma treated using IMRT based on the RTOG 0225 and RTOG 0615 protocols.
Figure 3
Figure 3
Local relapse-free survival, regional relapse-free survival and distant metastasis-free survival for 455 patients with nasopharyngeal carcinoma treated using IMRT based on the RTOG 0225 and RTOG 0615 protocols.
See this image and copyright information in PMC

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