Abstract
Objective: This study evaluated the outcome of intensity-modulated radiation therapy with simultaneous integrated boost and concurrent chemotherapy for nasopharyngeal cancer. Methods: We analyzed 53 consecutive nasopharyngeal cancer patients who received definitive treatment using intensity-modulated radiation therapy with simultaneous integrated boost and cisplatin-based concurrent chemotherapy. Forty-six patients were treated with concurrent chemoradiation and seven patients with induction chemotherapy plus concurrent chemoradiation. The gross tumor (PTV. 70) received 69.96 Gy (2.12 Gy/fraction), high-risk subclinical disease (PTV. 60) received 59.4 Gy (1.8 Gy/fraction) and low-risk subclinical disease (PTV. 56) received 56.1 Gy (1.7 Gy/fraction) in 33 fractions. Twenty-eight patients were treated with step-and-shoot intensity-modulated radiation therapy and 25 patients with helical tomotherapy. Dosimetric parameters were compared between the two modalities. Results: The median treatment duration was 49 days (range: 41-65 days). The complete response rate was 92.5%. Three local, two regional, one locoregional and seven distant failures were observed. With the median follow-up of 41 months (range: 8-89 months), the 3- and 5-year local control, locoregional control, disease-free survival and overall survival rates were 91.8 and 91.8%; 87.6 and 87.6%; 77.5 and 70.5%; and 86.4 and 82.1%, respectively. Grade 3 mucositis, dermatitis, leucopenia and grade 4 leucopenia were observed in 10, 1, 2 and 1 patient, respectively. No grade 3 or higher xerostomia occurred. Helical tomotherapy significantly improved dosimetric parameters including the maximum dose, volume receiving >107% of the prescribed dose and uniformity index (D5/D95). Conclusions: Intensity-modulated radiation therapy with simultaneous integrated boost with concurrent chemotherapy is a safe and effective treatment modality for nasopharyngeal cancer. Helical tomotherapy has a dosimetric advantage over step-and-shoot intensity-modulated radiation therapy in a clinical setting.
| Original language | English |
|---|---|
| Article number | hys169 |
| Pages (from-to) | 1152-1160 |
| Number of pages | 9 |
| Journal | Japanese Journal of Clinical Oncology |
| Volume | 42 |
| Issue number | 12 |
| DOIs | |
| Publication status | Published - 2012 Dec 1 |
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All Science Journal Classification (ASJC) codes
- Oncology
- Radiology Nuclear Medicine and imaging
- Cancer Research
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IMRT with simultaneous integrated boost and concurrent chemotherapy for nasopharyngeal cancer : Plan evaluation and treatment outcome. / Kim, Jun Won; Cho, Jae Ho; Keum, Ki Chang; Kim, Joo Ho; Kim, Gwi Eon; Lee, Jong Young; Kim, Soo Kon; Lee, Chang Geol.
In: Japanese Journal of Clinical Oncology, Vol. 42, No. 12, hys169, 01.12.2012, p. 1152-1160.Research output: Contribution to journal › Article
TY - JOUR
T1 - IMRT with simultaneous integrated boost and concurrent chemotherapy for nasopharyngeal cancer
T2 - Plan evaluation and treatment outcome
AU - Kim, Jun Won
AU - Cho, Jae Ho
AU - Keum, Ki Chang
AU - Kim, Joo Ho
AU - Kim, Gwi Eon
AU - Lee, Jong Young
AU - Kim, Soo Kon
AU - Lee, Chang Geol
PY - 2012/12/1
Y1 - 2012/12/1
N2 - Objective: This study evaluated the outcome of intensity-modulated radiation therapy with simultaneous integrated boost and concurrent chemotherapy for nasopharyngeal cancer. Methods: We analyzed 53 consecutive nasopharyngeal cancer patients who received definitive treatment using intensity-modulated radiation therapy with simultaneous integrated boost and cisplatin-based concurrent chemotherapy. Forty-six patients were treated with concurrent chemoradiation and seven patients with induction chemotherapy plus concurrent chemoradiation. The gross tumor (PTV. 70) received 69.96 Gy (2.12 Gy/fraction), high-risk subclinical disease (PTV. 60) received 59.4 Gy (1.8 Gy/fraction) and low-risk subclinical disease (PTV. 56) received 56.1 Gy (1.7 Gy/fraction) in 33 fractions. Twenty-eight patients were treated with step-and-shoot intensity-modulated radiation therapy and 25 patients with helical tomotherapy. Dosimetric parameters were compared between the two modalities. Results: The median treatment duration was 49 days (range: 41-65 days). The complete response rate was 92.5%. Three local, two regional, one locoregional and seven distant failures were observed. With the median follow-up of 41 months (range: 8-89 months), the 3- and 5-year local control, locoregional control, disease-free survival and overall survival rates were 91.8 and 91.8%; 87.6 and 87.6%; 77.5 and 70.5%; and 86.4 and 82.1%, respectively. Grade 3 mucositis, dermatitis, leucopenia and grade 4 leucopenia were observed in 10, 1, 2 and 1 patient, respectively. No grade 3 or higher xerostomia occurred. Helical tomotherapy significantly improved dosimetric parameters including the maximum dose, volume receiving >107% of the prescribed dose and uniformity index (D5/D95). Conclusions: Intensity-modulated radiation therapy with simultaneous integrated boost with concurrent chemotherapy is a safe and effective treatment modality for nasopharyngeal cancer. Helical tomotherapy has a dosimetric advantage over step-and-shoot intensity-modulated radiation therapy in a clinical setting.
AB - Objective: This study evaluated the outcome of intensity-modulated radiation therapy with simultaneous integrated boost and concurrent chemotherapy for nasopharyngeal cancer. Methods: We analyzed 53 consecutive nasopharyngeal cancer patients who received definitive treatment using intensity-modulated radiation therapy with simultaneous integrated boost and cisplatin-based concurrent chemotherapy. Forty-six patients were treated with concurrent chemoradiation and seven patients with induction chemotherapy plus concurrent chemoradiation. The gross tumor (PTV. 70) received 69.96 Gy (2.12 Gy/fraction), high-risk subclinical disease (PTV. 60) received 59.4 Gy (1.8 Gy/fraction) and low-risk subclinical disease (PTV. 56) received 56.1 Gy (1.7 Gy/fraction) in 33 fractions. Twenty-eight patients were treated with step-and-shoot intensity-modulated radiation therapy and 25 patients with helical tomotherapy. Dosimetric parameters were compared between the two modalities. Results: The median treatment duration was 49 days (range: 41-65 days). The complete response rate was 92.5%. Three local, two regional, one locoregional and seven distant failures were observed. With the median follow-up of 41 months (range: 8-89 months), the 3- and 5-year local control, locoregional control, disease-free survival and overall survival rates were 91.8 and 91.8%; 87.6 and 87.6%; 77.5 and 70.5%; and 86.4 and 82.1%, respectively. Grade 3 mucositis, dermatitis, leucopenia and grade 4 leucopenia were observed in 10, 1, 2 and 1 patient, respectively. No grade 3 or higher xerostomia occurred. Helical tomotherapy significantly improved dosimetric parameters including the maximum dose, volume receiving >107% of the prescribed dose and uniformity index (D5/D95). Conclusions: Intensity-modulated radiation therapy with simultaneous integrated boost with concurrent chemotherapy is a safe and effective treatment modality for nasopharyngeal cancer. Helical tomotherapy has a dosimetric advantage over step-and-shoot intensity-modulated radiation therapy in a clinical setting.
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UR - http://www.scopus.com/inward/citedby.url?scp=84870435613&partnerID=8YFLogxK
U2 - 10.1093/jjco/hys169
DO - 10.1093/jjco/hys169
M3 - Article
C2 - 23077243
AN - SCOPUS:84870435613
VL - 42
SP - 1152
EP - 1160
JO - Japanese Journal of Clinical Oncology
JF - Japanese Journal of Clinical Oncology
SN - 0368-2811
IS - 12
M1 - hys169
ER -